New phase 3 data show Vera Therapeutics’ Trutakna successfully stabilizes kidney function in IgA nephropathy patients, mirroring an earlier clinical success from Otsuka’s Voyxact and heating up competition in a rapidly evolving market race.
Trutakna helped IgAN patients achieve an annualized estimated glomerular filtration rate (eGFR) decline of 0.6 mL/min/1.73m² over two years, meeting the treatment goal of reducing loss to within 1 mL/min/1.73m² per year, as set by the KDIGO 2025 Clinical Practice Guideline for IgAN in accordance with normal physiologic age-related decline.
The result came from the final efficacy analysis of the Origin 3 trial in adults with primary IgAN at risk for disease progression, setting Vera up to seek an FDA conversion of Trutakna’s recent accelerated approval into a full nod. IgAN drugs are typically approved first based on their ability to reduce the abnormal presence of protein in the urine, whereas eGFR, which measures kidney function, can support a traditional approval.
By standalone performance, Trutakna’s eGFR change was numerically weaker than Voyxact’s 0.3 mL/min/1.73m² annualized gain measured over two years as shown in the phase 3 Visionary trial. However, Trutakna’s treatment effect over placebo, at 5 mL/min/1.73m², was numerically better than Voyxact’s 4.5 mL/min/1.73m² by cross-trial comparison.
Despite Trutakna’s slightly bigger efficacy delta against placebo, Evercore ISI analysts said they “wouldn’t make the claim Trutakna is more efficacious,” adding that the Vera drug “certainly is not less efficacious.”
Previously, at one year, Trutakna registered a mean eGFR change of 0.1 mL/min/1.73m² in absolute decline from baseline and a 5.6 mL/min/1.73m² treatment effect against placebo. By comparison, Voyxact’s mean eGFR change at one year was a 0.7 mL/min/1.73m² gain and a 5.5 mL/min/1.73m² treatment effect versus placebo.
While it’s difficult to call a winner between the two drugs based on eGFR data, Jefferies analysts called out one Trutakna data point that’s “perhaps most differentiated.” The Vera drug reduced the risk of composite kidney disease progression by 76%. No patient who took Trutakna had dialysis beyond 30 days, transplant or death through two years, versus eight patients on placebo.
As the Jefferies analysts noted, Voyxact currently does not have detailed data on those kidney protection analyses. Evercore analysts also dubbed the progression results “incredibly supportive” of Trutakna.
“Prevention of kidney failure or kidney-related death is the ultimate goal,” Richard Lafayette, M.D., from Stanford University Medical Center and a principal investigator for Origin 3, said in a Sept. 15 statement. “We now have evidence suggesting that Trutakna may help patients avoid dialysis, transplantation, or kidney-related death over the long term.”
Voyxact is the first drug that targets A proliferation-inducing ligand (APRIL). Trutakna inhibits both APRIL and B-cell activating factor (BAFF). Vertex’s BAFF/APRIL candidate povetacicept also awaits an FDA decision in IgAN by Nov. 30, 2026.
Alongside its Origin 3 announcement Tuesday, Vera disclosed that Trutakna has accumulated more than 350 patient start forms in the first ten weeks since an FDA accelerated approval in early July. Both Evercore and Jefferies analysts said the early number suggests a strong launch.
“It counters the bear argument that Otsuka has already penetrated the most enthusiastic early-adopter docs,” the Jefferies team wrote in a Sept. 15 note.