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诺华Fabhalta®（iptacopan）III期试验达到主要终点，减缓IgA肾病（IgAN）患者肾功能下降

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  • In APPLAUSE-IgAN final analysis, Fabhalta demonstrated statistically significant, clinically meaningful improvement in estimated glomerular filtration rate (eGFR) slope vs. placebo over two years1

  • eGFR is key marker of kidney function; IgAN is progressive autoimmune kidney disease that leads to kidney failure in many patients1-3 

  • Fabhalta is first and only approved complement inhibitor for adults with IgAN and has potential to delay disease progression4,5 

  • Fabhalta received accelerated approval for reduction of proteinuria in adults with IgAN in US in 2024; data support 2026 submission for traditional FDA approval4,5 

 

Basel, October 16, 2025 – Novartis today announced positive final results from APPLAUSE-IgAN, a Phase III study evaluating Fabhalta® (iptacopan) in adults living with IgA nephropathy (IgAN). Fabhalta, an oral alternative complement pathway inhibitor, demonstrated statistically significant, clinically meaningful superiority compared to placebo in slowing IgAN progression measured by annualized total slope of estimated glomerular filtration rate (eGFR) decline over two years1.  

 

“Progressive diseases such as IgAN present an urgent need for interventions that can ultimately improve kidney health. Many people with IgAN commonly experience fear and anxiety of disease progression,” said Ruchira Glaser, Development Unit Head, Cardiovascular, Renal & Metabolic, Novartis. “We are excited about today’s positive Phase III APPLAUSE-IgAN results showing slowed eGFR decline, which add to the growing evidence of Fabhalta as a targeted therapy to preserve long-term kidney function, giving hope to people living with this condition.” 

Novartis intends to use these data to support Fabhalta submissions in 2026. Alongside Fabhalta, Novartis continues to advance its multi-asset IgAN portfolio, which also includes Vanrafia® (atrasentan) and investigational compound zigakibart.

IgAN is a progressive autoimmune kidney disease with approximately 25 per million people newly diagnosed worldwide each year3. IgAN is highly debilitating as it leads to glomerular inflammation, proteinuria, and a gradual decline in eGFR2. Up to 50% of patients with persistent proteinuria progress to kidney failure within 10 to 20 years of diagnosis, often requiring dialysis or kidney transplantation as part of long-term disease management2,6,7. Furthermore, people living with IgAN often face mental, social, and economic challenges2,8. Supportive care does not address the underlying causes of the disease and often fails to slow disease progression, reinforcing the need for more targeted therapies for IgAN3,9.

In APPLAUSE-IgAN, Fabhalta was well tolerated with a favorable safety profile in line with previously reported data10. Full data from the APPLAUSE-IgAN final analysis will be presented at future medical meetings. 

About Fabhalta® (iptacopan) 


Fabhalta (iptacopan) is an oral, Factor B inhibitor of the alternative complement pathway10. 

 

Discovered at Novartis, Fabhalta received US Food and Drug Administration (FDA) and European Commission (EC) approval in December 2023 and May 2024, respectively, for the treatment of adults with paroxysmal nocturnal hemoglobinuria (PNH). Fabhalta also received accelerated approval in the US in August 2024, and in China in September 2025, for the reduction of proteinuria in adults with primary IgA nephropathy (IgAN) at risk of rapid disease progression (generally UPCR ≥1.5 g/g4,5,11,12. In 2025, Fabhalta received FDA and EC approval as well as approvals in China and Japan for the treatment of adults with C3 glomerulopathy (C3G), making it the first treatment approved for this condition13-15. 

 

Fabhalta is being studied in a broad range of rare kidney diseases, including atypical hemolytic uremic syndrome (aHUS), immune complex membranoproliferative glomerulonephritis (IC-MPGN) and lupus nephritis (LN)16-18. Studies are ongoing to evaluate the safety and efficacy profiles in these investigational indications and support potential regulatory submissions16-18. 

 

About APPLAUSE-IgAN 


APPLAUSE-IgAN (NCT04578834) is a Phase III multicenter, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of twice-daily oral Fabhalta (200 mg) in 477 adult primary IgAN patients (main study population). Patients were randomized to Fabhalta or placebo, on top of supportive care (a stable dose of maximally-tolerated renin-angiotensin system (RAS) inhibitor therapy with or without a stable dose of SGLT2i)1.    

 

The two primary endpoints of the study for the interim and final analysis, respectively, are proteinuria reduction at 9 months as measured by UPCR, and the annualized total eGFR slope over 24 months10,18. During the final analysis, the following secondary endpoints were assessed: proportion of participants reaching UPCR <1 g/g without receiving corticosteroids/immunosuppressants or other newly approved drugs or initiating new background therapy for treatment of IgAN or initiating kidney replacement therapy (KRT), time from randomization to first occurrence of composite kidney failure endpoint event (reaching either sustained ≥30% decline in eGFR relative to baseline or sustained eGFR <15 mL/min/1.73 m2 or maintenance dialysis or receipt of kidney transplant or death from kidney failure), and change from baseline to 9 months in the fatigue scale measured by the Functional Assessment Of Chronic Illness Therapy-Fatigue questionnaire19.    

 

The main study population enrolled patients with an eGFR ≥30 mL/min/1.73 m2 and UPCR ≥1 g/g at baseline10,18. In addition, a smaller cohort of patients with severe renal impairment (eGFR 20–30 mL/min/1.73 m2 at baseline) was also enrolled to provide additional information but not contributing to the main efficacy analyses10,19. 

 

About Novartis 


Novartis is an innovative medicines company. Every day, we work to reimagine medicine to improve and extend people’s lives so that patients, healthcare professionals and societies are empowered in the face of serious disease. Our medicines reach nearly 300 million people worldwide.

 

References

  1. Novartis. Data on file. 

  2. Kwon CS, Daniele P, Forsythe A et al. A systematic literature review of the epidemiology, health-related quality of life impact, and economic burden of immunoglobulin a nephropathy. J Health Econ Outcomes Res 2021;8:36–45. 

  3. Cheung C, Barratt J. The rapidly changing treatment landscape of IgA nephropathy. Semin Nephrol 2025;44:151573. 

  4. Novartis Pharmaceuticals Corporation. Fabhalta prescribing information. 2023 (2025 update). Available at: https://www.novartis.com/us-en/sites/novartis_us/files/fabhalta.pdf (accessed October 2025). 

  5. Novartis Pharmaceuticals Corporation. Novartis receives FDA accelerated approval for Fabhalta® (iptacopan), the first and only complement inhibitor for the reduction of proteinuria in primary IgA nephropathy (IgAN) (2024). Available at: https://www.novartis.com/news/media-releases/novartis-receives-fda-accelerated-approval-fabhalta-iptacopan-first-and-only-complement-inhibitor-reduction-proteinuria-primary-iga-nephropathy-igan (accessed October 2025). 

  6. Pitcher D, Braddon F, Hendry B et al. Long-term outcomes in IgAN. Clin J Am Soc Nephrol 2023;18:727–8.

  7. Mohd R, Mohammad Kazmin NE, Abdul Cader R, et al. Long-term outcome of immunoglobulin A (IgA) nephropathy: a single center experience. PLoS One. 2021;16:e0249592. 

  8. National Kidney Foundation. The voice of the patient (2020). Available at: https://igan.org/wp-content/uploads/2021/01/VOP_IgAN_12-7-20__FNL.pdf (accessed October 2025).

  9. Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney Int 2021;100:S1–276. 

  10. Perkovic V, Barratt J, Rovin B, et al. Alternative complement pathway inhibition with iptacopan in IgA nephropathy. N Engl J Med. 2025;392:531–543.

  11. Fabhalta®. EMA Summary of Product Characteristics. Novartis Europharm Limited (2024). Available at: https://www.ema.europa.eu/en/documents/product-information/fabhalta-epar-product-information_en.pdf (accessed October 2025). 

  12. PHARMCUBE. Novartis expands indications for iptacopan, capmatinib in China (2025). Available at: Novartis Expands Indications for Iptacopan, Capmatinib in China PharmCube-News & Reports (accessed October 2025). 

  13. Fineline Cube. Novartis’ fabhalta approved in China for C3 glomerulopathy (2025). Available at: Novartis' Fabhalta Approved in China for C3 Glomerulopathy - Insight, China's Pharmaceutical Industry (accessed October 2025). 

  14. Pharma Japan. Novartis makes full foray into nephrology space with fabhalta: exec (2025). Available at: Novartis Makes Full Foray into Nephrology Space with Fabhalta: Exec | PHARMA JAPAN (accessed October 2025).

  15. Novartis. Press release. Novartis receives third FDA approval for oral Fabhalta® (iptacopan) – the first and only treatment approved in C3 glomerulopathy (C3G) (2025). Available at: https://www.novartis.com/news/media-releases/novartis-receives-third-fda-approval-oral-fabhalta-iptacopan-first-and-only-treatment-approved-c3-glomerulopathy-c3g (accessed October 2025). 

  16. Clinicaltrials.gov. NCT04889430. Efficacy and Safety of Iptacopan (LNP023) in Adult Patients with Atypical Hemolytic Uremic Syndrome Naive to Complement Inhibitor Therapy (APPELHUS). Available at: https://clinicaltrials.gov/study/NCT04889430 (accessed October 2025).  

  17. Clinicaltrials.gov. NCT05755386. Study of Efficacy and Safety of Iptacopan in Participants With IC-MPGN (APPARENT). Available at: https://clinicaltrials.gov/study/NCT05755386 (accessed October 2025). 

  18. Clinicaltrials.gov. NCT05268289. Study of Efficacy and Safety of LNP023 in Participants With Active Lupus Nephritis Class III-IV, +/ - V. Available at: https://clinicaltrials.gov/study/NCT05268289 (accessed October 2025). 

  19. Rizk DV, Rovin BH, Zhang H et al. Targeting the alternative complement pathway with iptacopan to treat IgAN: design and rationale of the APPLAUSE-IgAN study. Kidney Int Rep 2023;8:968–79. 

文章关键词： 诺华Fabhalta®（iptacopan）IgA肾病（IgAN）
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