Rizk DV, Barratt J, Suzuki Y, et al. Sibeprenlimab in IgA Nephropathy: Final Phase 3 Trial Analysis (VISIONARY). N Engl J Med, 2026

DOI 10.1056/NEJMoa2609127

Double-blind phase 3 RCT, 510 adults with biopsy-proven primary IgA nephropathy at risk of progression, sibeprenlimab vs placebo on supportive care for 2 years (Otsuka). Annualised eGFR slope +0.3 vs -4.2 mL/min/1.73 m2/year (difference 4.5; 95% CI 3.6-5.4). Composite of sustained >=40% eGFR decline, creatinine doubling, eGFR <15 or kidney replacement: 1/259 vs 28/251. Kidney replacement therapy 0 vs 5.