Let's know everything about Tarpeyo, a medicine for the kidney disease called IgA Nephropathy.

The kidneys are one of the most important organs in our body. But sometimes, changes in our own immune system can damage the kidneys. One such condition is primary immunoglobulin A nephropathy, or simply IgA nephropathy. In this, an antibody called IgA accumulates in the kidneys, causing them to swell and not function properly. Today, we will talk about this disease and the special medicine called Tarpeyo that is given for it.

How does the drug Tarpeyo work?

Simply put, IgA Nephropathy starts when our body starts producing abnormal IgA antibodies (IgA1). Normally, antibodies are like the sentinels of our immune system. They protect us from things like bacteria and viruses. But in this disease, there is a small defect in the IgA antibodies that are produced. These defective antibodies stick together and form large clumps. Our immune system looks at these clumps as if they were an enemy. So, the immune system starts fighting these clumps. This battle takes place inside the kidneys. This causes inflammation in the delicate filtering units inside the kidneys, called glomeruli. Over time, this inflammation causes scarring in those areas and damages the kidneys. A person with this disease may not experience much discomfort at first. However, over time, these symptoms may appear due to damage to the kidneys. Doctors usually treat this disease by controlling symptoms such as high blood pressure and giving medications that control the immune system. This includes medications such as immunosuppressants and corticosteroids. However, these common medications can have many unwanted side effects when taken long-term. This is where the drug Tarpeyo comes in. Tarpeyo is also a corticosteroid, but its specialty is that it goes to the very place where the problematic IgA antibodies are produced. The antibodies are produced in a specific part of our intestine called the ileum. Tarpeyo goes directly there and reduces the production of this incorrect IgA1. Therefore, inflammation and damage to the kidneys are reduced, and the long-term side effects of common steroid medications are also reduced.

How should I use this medicine?

Tarpeyo is a medicine that comes in capsule form. It should be taken every morning, at least an hour before meals .

• Do not break, chew, or crush the medicine. It should be swallowed whole.
• Do not eat grapefruit or drink grapefruit juice while taking this medication. We'll talk about why later.

Very important: Do not stop taking this medicine without talking to your doctor. When you continue to take corticosteroids like Tarpeyo, your body stops producing the steroid hormones that it naturally produces. If you stop taking the medicine suddenly, your body will lose the amount of steroids it needs and you may experience withdrawal symptoms. For example, you may experience extreme tiredness, body aches, nausea, low blood pressure, and headaches. Therefore, if you stop taking the medicine, you should do so gradually by reducing the dose (tapering) . Your doctor will tell you the correct way to do this.

How have the benefits of this medicine been studied?

In a major study to see the safety and effectiveness of Tarpeyo, it was compared with a placebo. A placebo is a dummy pill that contains no medicine. This is to see what the difference is between people who took the real medicine and those who took the dummy pill. All of the participants in the study had IgA nephropathy and had extra protein in their urine. All of them were also taking blood pressure medications, such as ACE inhibitors or ARBs, which reduce the pressure on the kidneys. The participants were selected based on two criteria:

• Urine protein-to-creatinine ratio (UPCR): This measures how much protein is excreted in the urine within 24 hours.
• Estimated glomerular filtration rate (eGFR): This measures how well your kidneys are working and how well they filter waste. The people in the study had mild to moderate kidney function decline.

In this study, one group was given Tarpeyo for 9 months, and the other group was given a placebo. After 9 months, the treatment was stopped and they were monitored for another 15 months.

What benefits have been shown in studies?

The study showed that people who took Tarpeyo had significantly less kidney damage than those who took a placebo. This benefit continued after 9 months of taking the drug.

Decreased protein levels in the urine

At the end of 9 months, protein levels in the urine of those taking Tarpeyo decreased by 35%, compared to only 5% in those taking the placebo. This reduction was maintained for 24 months.

Kidney function (eGFR)

At the end of 24 months, those who took Tarpeyo had a much smaller decline in kidney function than those who took placebo. A positive (+) value means that kidney function has improved, and a negative (-) value means that it has worsened. This study showed that taking Tarpeyo for 9 months can slow down the damage to the kidneys. This can help control symptoms and delay kidney failure. But keep in mind that these results may vary from person to person.

How to prevent and manage side effects?

Tarpeyo is a medicine that suppresses the immune system, so you are more likely to get infections. You may get colds, flu, and urinary tract infections more often. Stay away from people who have contagious diseases like chickenpox and measles. The best way to prevent infections is to wash your hands often and stay away from people who are sick. Talk to your doctor about getting vaccinations. Call your doctor right away if you have any of these signs of infection:

• Fever or chills
• Body pain
• Cough
• Extreme fatigue
• Persistent headache
• Vision changes or memory loss
• A painful blow

Tarpeyo may cause swelling or high blood pressure . Talk to your doctor about a healthy lifestyle, including diet and exercise. Reducing salt in your diet, drinking plenty of water, and doing light exercise like walking can help reduce swelling and control blood pressure. Other common side effects include nausea, stomach upset, muscle cramps, acne, and headaches . If you have acne, follow a good skin care routine, such as gentler cleansers and oil-free moisturizers. These are not all of the possible side effects. If you have any symptoms that bother you, talk to your doctor about them.

What tests should be done while taking the medicine?

Your doctor will order various tests to see how your body is responding to the medication. These are the main ones:

• Blood pressure measurement
• Urinalysis to check the amount of protein in the urine
• Blood tests to check kidney function
• Blood test for hepatitis B virus

What other things can interact with this medicine?

Some medications and foods can affect the way Tarpeyo works. Therefore, it is very important to tell your doctor about all the medications you are taking (including vitamins and herbal products) . Be especially careful about the following:

• Some antifungal and antibiotic medications (e.g., clarithromycin (Biaxin), itraconazole (Sporanox), ketoconazole (Nizoral))
• Some medications used for HIV
• Grapefruit or grapefruit juice

This is not a complete list, so be sure to tell your doctor about everything you take.

Find out how you can get this medicine.

Tarpeyo is a specialty drug. This means that it is expensive and is used for specific medical conditions. Therefore, it may not be available at all pharmacies. Usually, this type of medication is available at hospital pharmacies or specialty pharmacies. Your doctor will guide you through the process of obtaining this medication and where to get it. IgA nephropathy, Tarpeyo, kidney disease, protein in urine, eGFR, corticosteroid, immune system