IgA nephropathy is the most common inflammatory kidney disease among the glomerulonephritides. Berger and Hinglais described the disease in 1968. 1 Berger J Hinglais N Les ddpôts intercapillaires d'IgA-IgG. J Urol Nephrol (Paris). 1968; 74: 694-695 PubMed Google Scholar IgA nephropathy is generally considered a benign kidney disease, which is true if compared to many vasculitides, but false in view of a recent analysis of real-world data from the UK National Registry of Rare Kidney Diseases (RaDaR), 2 Floege J Rauen T Tang SCW Current treatment of IgA nephropathy. Semin Immunopathol. 2021; 43: 717-728 Crossref PubMed Scopus (41) Google Scholar which found that patients with IgA nephropathy had a median kidney survival time (until kidney failure, all-cause death, or end of follow-up) of only 11·4 years (95% CI 10·5–12·5). Therapy is mainly supportive and based on blood pressure control and blockade of the renin-angiotensin system (RAS). 3 Pitcher D Braddon F Hendry B et al. Long-term outcomes in IgA nephropathy. Clin J Am Soc Nephrol. 2023; 18: 727-738 Crossref PubMed Scopus (12) Google Scholar Most patients are treated by a nephrologist, but some are treated by their general practitioner. Considering that almost all patients with IgA nephropathy develop renal failure within their lifetime, 2 Floege J Rauen T Tang SCW Current treatment of IgA nephropathy. Semin Immunopathol. 2021; 43: 717-728 Crossref PubMed Scopus (41) Google Scholar it seems evident that these patients need improvements in therapy and disease-modifying therapies. Efficacy and safety of a targeted-release formulation of budesonide in patients with primary IgA nephropathy (NefIgArd): 2-year results from a randomised phase 3 trialA 9-month treatment period with Nefecon provided a clinically relevant reduction in eGFR decline and a durable reduction in proteinuria versus placebo, providing support for a disease-modifying effect in patients with IgA nephropathy. Nefecon was also well tolerated, with a safety profile as expected for a locally acting oral budesonide product. Full-Text PDF