atacicept (VT-001) / EMD Serono, Vera Therap - LARVOL DELTA

Emerging Therapies in IgA Nephropathy: From A Proliferation-Inducing Ligand (APRIL) and B-cell Activating Factor (BAFF) Inhibitors to Precision Medicine. (PubMed, Cureus) - "This review synthesizes current evidence on evolving treatments, with a focus on A Proliferation-Inducing Ligand (APRIL) and B-cell Activating Factor (BAFF) (e.g., sibeprenlimab, atacicept, povetacicept, telitacicept), complement pathway modulators (e.g., iptacopan, cemdisiran, ravulizumab), and novel agents such as felzartamab and sparsentan. It also explores precision medicine strategies, including biomarker-guided therapy, individualized risk stratification, and combination regimens. Supported by high-quality recent clinical trial data and the latest kidney disease outcome guidelines, these innovations represent a paradigm shift toward personalized, disease-modifying treatment in IgAN, offering a new horizon for improved renal outcomes and long-term disease control."

Journal • Review • Chronic Kidney Disease • Glomerulonephritis • IgA Nephropathy • Nephrology • Renal Disease

Reduced BCMA Signaling Disrupts the BAFF/APRIL Axis and Promotes Inflammatory Cytokine Production by B Cells in Multiple Sclerosis. (ACTRIMS Forum 2026) - "While anti-CD20 therapies reduce disease activity, atacicept, an inhibitor of BAFF and APRIL, unexpectedly worsened MS, revealing a paradox in B cell biology... Our findings identify a critical BCMA-dependent BAFF/APRIL signaling axis that maintains immune homeostasis by promoting regulatory B cell function and restraining inflammatory B cell activation. Reduced transitional B cells and impaired BCMA signaling in MS may drive pathogenic B cell responses and disease activity. Targeting this pathway could restore immune balance and provide a therapeutic strategy that preserves protective B cells while limiting inflammation."

IO biomarker • CNS Disorders • Immunology • Inflammation • Multiple Sclerosis • IL10 • IL6 • NEFL

A plain language summary: long-term safety and effectiveness of atacicept in individuals with IgA nephropathy. (PubMed, Curr Med Res Opin) - No abstract available

Journal • Glomerulonephritis • IgA Nephropathy • Renal Disease

Vera Therapeutics Announces U.S. FDA Granted Priority Review to Biologics License Application for Atacicept for Treatment of Adults with IgA Nephropathy (GlobeNewswire) - "The BLA, which was submitted using the Accelerated Approval Program, was assigned a Prescription Drug User Fee Act (PDUFA) target action date of July 7, 2026....The BLA submission for atacicept is supported by data from a prespecified interim analysis of the ORIGIN 3 trial, which met the primary endpoint of reduction in proteinuria at week 36."

FDA filing • PDUFA • Priority review • IgA Nephropathy

Efficacy and safety of BAFF/APRIL dual antagonists in IgA nephropathy: a systematic review and meta-analysis of randomized controlled trials. (PubMed, BMC Nephrol) - No abstract available

Journal • Retrospective data • Glomerulonephritis • IgA Nephropathy • Renal Disease

PIONEER: A Basket Trial of Atacicept in Autoimmune Mediated Glomerular Disease (KIDNEY WEEK 2025) - "Eligible pts will receive atacicept 150 mg via at-home once-weekly subcutaneous injection for up to 52 weeks. Key efficacy endpoints will include changes from baseline in UPCR, eGFR, and disease-specific antibody levels."

Pan tumor • Chronic Kidney Disease • Focal Segmental Glomerulosclerosis • Glomerulonephritis • IgA Nephropathy • Immunology • Nephrology • Renal Disease

Vera Therapeutics Submits Biologics License Application to U.S. FDA through Accelerated Approval Program for Atacicept for the Treatment of Adults with IgA Nephropathy (GlobeNewswire) - "The BLA submission for atacicept is supported by data from a prespecified interim analysis of the ORIGIN 3 trial, which met the primary endpoint of reduction in proteinuria at week 36....Potential FDA approval in 2026."

FDA approval • FDA filing • IgA Nephropathy

ORIGIN 3: A Phase 3 Trial of Atacicept in IgAN (KIDNEY WEEK 2025) - No abstract available

P3 data • Glomerulonephritis • IgA Nephropathy

Imbalanced Expression of TACI Isoforms Regulated By TNFRSF13B Variants Promotes the Progression of Epstein-Barr Virus-Associated Lymphoproliferative Diseases (ASH 2024) - "For patients who carry the gain-of-function germline mutations of TNFRSF13B, the inhibitory TACI-Ig or the TACI ligands BAFF and APRIL may efficiently prevent the serious progression of their EBV infection. Screening for possibly pathogenic variants, especially in the TNF-TNFR superfamily genes in EBV-LPD patients is necessary and valuable for understanding the pathogenesis of EBV-LPDs and optimizing the therapeutic regimen."

Epstein-Barr Virus Infections • Infectious Disease • TNFA • TNFRSF13B • TUSC3 • UNC13D

ORIGIN Extend: A Long-Term Extension Study of Atacicept in IgAN (KIDNEY WEEK 2025) - "ORIGIN Extend will provide pts continued access to atacicept, capture longer-term safety and efficacy data, and explore reinitiation of atacicept following an off-treatment period. 1 Barratt J. JASN 2024."

Glomerulonephritis • IgA Nephropathy • Nephrology • Renal Disease

A Phase 3 Trial of Atacicept in Patients with IgA Nephropathy. (PubMed, N Engl J Med) - P3 | "In this prespecified interim analysis, treatment with atacicept resulted in a significantly greater reduction in proteinuria than placebo at week 36 in patients with IgA nephropathy. (Funded by Vera Therapeutics; ORIGIN 3 ClinicalTrials.gov number, NCT04716231.)."

Journal • P3 data • Glomerulonephritis • IgA Nephropathy • Nephrology • Renal Disease

The Use Of Preclinical Models To Understand Drivers Of Lupus Pathogenesis (ACR Convergence 2025) - "Overexpression of IFNα via hydrodynamic DNA delivery (HDD) was used to evaluate the role of IFNα in these strains, while TACI-Ig-mediated B cell depletion was performed to determine the contribution of B cells to pathogenesis. The respective contributions of IFNa and BAFF, representing pathways with approved targeted therapeutics in SLE, were evaluated and analyzed between these strains... Here we describe two models of SLE-like disease that respond differently to manipulation of key pathways targeted by existing approved therapeutics. Taken together, these data suggest that NZB/W and C9orf72-/- mice recapitulate distinct disease mechanisms relevant to human patients and can be used in preclinical efforts to validate therapeutic strategies for a heterogeneous SLE patient population."

Preclinical • Immunology • Inflammatory Arthritis • Lupus • Renal Disease • Systemic Lupus Erythematosus • IFNA1

Atacicept in Multiple Glomerular Diseases (clinicaltrials.gov) - P2 | N=200 | Recruiting | Sponsor: Vera Therapeutics, Inc. | Not yet recruiting ➔ Recruiting

Enrollment open • Focal Segmental Glomerulosclerosis • Glomerulonephritis • IgA Nephropathy • Immunology • Nephrology • Renal Disease

Monthly Dosing of Atacicept in IgAN (clinicaltrials.gov) - P2 | N=90 | Recruiting | Sponsor: Vera Therapeutics, Inc.

New P2 trial • Glomerulonephritis • IgA Nephropathy • Renal Disease

UNDERSTANDING DRIVERS OF LUPUS PATHOGENESIS THROUGH COMPARISON OF PRECLINICAL MODELS (EULAR 2025) - "B cell/plasma cell depletion by overexpressing TACI-Ig by HDD to bind and sequester BAFF and APRIL in the C9orf72-deficient lupus model reversed lupus-associated phenotypes... Here we describe two models of SLE-like disease that respond differently to manipulation of two of the pathways targeted by existing approved therapeutics. Taken together, these data suggest that NZB/W and C9orf72 -/- mice can recapitulate distinct disease mechanisms relevant in human lupus patients and can be used in preclinical efforts to validate therapeutic strategies to target a heterogeneous SLE patient population."

Preclinical • Immunology • Inflammation • Inflammatory Arthritis • Lupus • Renal Disease • Systemic Lupus Erythematosus

Upregulation of pro-survival receptors on antibody-secreting cells is linked to worse disease characteristics across SLE, Scleroderma and Sjögrens disease and offers potential new treatment angles (EULAR 2025) - "Given the divers disease manifestations in SLE, SSc and SjD, specific disease features in all three sARDs were investigated in the context of the blood ASC phenotypes. When engaged by the ligands CD80 or CD86, CD28 facilitates pro-survival signaling. Similarly, binding of the cytokines APRIL or BAFF to the ASC-specific receptors TACI and BCMA also induces pro-survival signals."

IO biomarker • Immunology • Inflammatory Arthritis • Lupus • Scleroderma • Sjogren's Syndrome • Systemic Lupus Erythematosus • Systemic Sclerosis • BCL2 • CD19 • CD20 • CD27 • CD28 • CD44 • CD80 • CD86 • CXCR3 • ITGA4 • MCL1 • NCAM1 • PRDM1 • SDC1

ORIGIN Extend: A Long-Term Extension Study of Atacicept in IgA Nephropathy (ERA 2025) - "The ORIGIN Extend study will provide patients with extended access to atacicept prior to commercial availability in their country or region, capture longer-term data for research purposes, and generate data from reinitiation of atacicept treatment following an off-treatment period."

Glomerulonephritis • IgA Nephropathy • Renal Disease

ORIGIN 3 Study Design: A Global, Randomized, Controlled, Phase 3 Study of Atacicept in IgA Nephropathy (ERA 2025) - "This pivotal Phase 3 study has a consistent design, patient population and atacicept dose and subcutaneous formulation with that of the completed ORIGIN Phase 2b study, which demonstrated the efficacy of atacicept in reducing Gd-IgA1, improving hematuria, reducing proteinuria, and stabilizing eGFR. This Phase 3 study will further evaluate atacicept's disease- modifying potential as a treatment for IgAN."

Clinical • P3 data • Glomerulonephritis • IgA Nephropathy • Lupus Nephritis • Renal Disease

ORIGIN 2b: Changes in Gd-IgA1 and eGFR After Discontinuation of Atacicept Treatment in IgA Nephropathy (ERA 2025) - "IgAN is a chronic and progressive disease of B-cell origin, in which cytokines BAFF and APRIL are sustaining factors in its pathophysiology. Treatment with atacicept, a precision B-cell modulator inhibiting both BAFF and APRIL, demonstrated significant and sustained reductions in Gd-IgA1, improvements in hematuria, and reductions in UPCR, along with stabilization of eGFR over 96 wk. Following discontinuation of atacicept, an increase in Gd-IgA1 and decline in eGFR were observed, consistent with the typical clinical progression of IgAN in high-risk patients despite standard-of-care treatments."

Glomerulonephritis • Hematological Disorders • IgA Nephropathy • Lupus Nephritis • Renal Disease

Differential Impacts of APRIL and APRIL/BAFF Inhibition on Immune Populations: Implications for IgAN Treatment and Protective Immunity (ERA 2025) - " Mice were dosed twice per week with anti-APRIL antibody (4540), or APRIL/BAFF inhibitors (TACI- Fc fusion proteins POV and ATA, based on the sequences of povetacicept and atacicept, respectively), or isotype control antibody (MOTA). This study demonstrates that administration of both APRIL and APRIL/BAFF inhibitors reduce serum IgA, a desirable effect for kidney diseases like IgA nephropathy, in which elevated levels of aberrantly glycosylated IgA have a pathogenic role. However, dual APRIL/BAFF inhibition leads to significant ablation of most B cell subsets, ASCs, and Tfh cells, whereas APRIL-only inhibition does not substantially alter splenic cell populations. Broad immune cell ablation has implications for immune homeostasis and responses to vaccines and pathogens."

Clinical • Glomerulonephritis • IgA Nephropathy • Infectious Disease • CD21 • PTPRC

Atacicept in Subjects With Active Lupus Nephritis (COMPASS) (clinicaltrials.gov) - P3 | N=0 | Withdrawn | Sponsor: Vera Therapeutics, Inc. | N=360 ➔ 0 | Suspended ➔ Withdrawn

Enrollment change • Trial withdrawal • Glomerulonephritis • Immunology • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology

Atacicept in Multiple Glomerular Diseases (clinicaltrials.gov) - P2 | N=200 | Not yet recruiting | Sponsor: Vera Therapeutics, Inc.

New P2 trial • Focal Segmental Glomerulosclerosis • Glomerulonephritis • IgA Nephropathy • Immunology • Nephrology • Renal Disease

ORIGIN: Atacicept in Subjects With IgA Nephropathy (clinicaltrials.gov) - P3 | N=376 | Active, not recruiting | Sponsor: Vera Therapeutics, Inc. | Recruiting ➔ Active, not recruiting

Enrollment closed • Glomerulonephritis • IgA Nephropathy • Renal Disease

ORIGIN EXTEND: A Rollover Study to Evaluate the Long-Term Safety and Efficacy of Atacicept (clinicaltrials.gov) - P2 | N=476 | Enrolling by invitation | Sponsor: Vera Therapeutics, Inc. | Recruiting ➔ Enrolling by invitation

Enrollment status • Glomerulonephritis • IgA Nephropathy • Renal Disease • CST3

Vera Therapeutics Completes Full Enrollment in Pivotal ORIGIN Phase 3 Trial for Atacicept in IgAN (GlobeNewswire) - "Vera Therapeutics, Inc...announced that it has completed full enrollment in the pivotal ORIGIN Phase 3 trial of atacicept in patients with IgA Nephropathy (IgAN)....The ORIGIN 3 trial (NCT04716231) is a global, multicenter, randomized, double-blind, placebo-controlled Phase 3 trial evaluating the safety and efficacy of atacicept in patients with IgAN who have persistent proteinuria and remain at high risk of disease progression. Participants are randomized 1:1 to at-home self-administered once-weekly subcutaneous injections of atacicept 150 mg or placebo for a 104-week double-blind period, followed by a 52-week open-label extension."

Enrollment closed • IgA Nephropathy