VIDEO: Complement inhibitors, other agents in the pipeline for glomerular diseases

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Various medications that inhibit complement seem very exciting. They're actually currently under investigation for a lot of different indications in nephrology, including all sorts of glomerular diseases. They began as medications used to treat atypical hemolytic uremic syndrome or thrombotic microangiopathies. But I think there's been a more recent recognition that a number of diseases with a number of different initial pathogeneses seem to be things that, if we slow down compliment activation, that seems to slow down the inflammation of the disease. And this is where this avacopan played in for ANCA disease.

But these various types of agents that block different parts of the complement cascade are of interest, I should say, in a wide variety of diseases ranging from immune complex diseases to vasculitis-type diseases well as pure proteinuric diseases. So conditions of nephrotic syndrome seem like another area where these agents might be sort of add-on to other therapies we have. I think the other area that's really exciting are agents focused on sort of reducing antibody production. So these would be things targeted at B-cells or plasma cells. There's been an interest in a number of pathways regarding antibody production and these agents have been of interest in lupus nephritis, for instance, but also the IgA nephropathy I mentioned.

So there's a lot of really exciting things that I think could potentially be coming down the pipeline the next few years. So I think it's really an exciting era, honestly, for glomerular disease.