An article in the New England Journal of Medicine (Volume 394, Issue 7, Pages 712-713, February 12, 2026) discusses a new treatment approach targeting the pathogenesis of IgA nephropathy. It emphasizes the importance of targeted therapy to slow disease progression in patients with IgAN. It features sibeprenlimab, an APRIL-blocking monoclonal antibody that produced dose-dependent, reversible decreases in serum IgA, Gd-IgA1, IgG, IgM, and APRIL concentrations in preclinical and phase 1 studies. The phase 2 clinical trial was a double-blind, randomized, placebo-controlled study conducted at 98 centers in 15 countries in adult patients with IgAN at high risk of progression. Sibeprenlimab was administered monthly to standard therapy with ACE inhibitors or AT receptor blockers. The primary endpoint was the decrease in proteinuria after 26 weeks. The study validates the efficacy and safety of APRIL suppression on the development of Gd-IgA1 as a key etiopathogenetic pathway. In at-risk patients without severe kidney damage, immunosuppressive therapy, especially glucocorticoids, is usually indicated.