Voyxact gets accelerated approval, offering investors a new entrant in the high-value kidney disease market.
The Food and Drug Administration (FDA) has granted accelerated approval to Otsuka Pharmaceutical’s Voyxact, the first therapy in an emerging class of medicines targeting the autoimmune kidney condition IgA nephropathy (IgAN) [1]. The decision positions Otsuka at the front of a rapidly expanding market, one that analysts estimate could be worth between $6 billion and $10 billion in the US alone.
IgAN, also known as Berger’s disease, is caused by a buildup of abnormal antibodies in the kidneys. These antibodies trigger inflammation and leave the organ leaking blood and protein, an early warning sign of progressive damage.
While multiple oral therapies exist, kidney function for many patients continues to decline, creating strong demand for new interventions that target the biology of the disease more directly.
“With its targeted mechanism, strong efficacy, safety profile, and once-every-four-weeks dosing, Voyxact offers a new option for IgAN patients,” said John Kraus, Otsuka’s chief medical officer. “We recognize the urgent need for new treatment options for IgAN and are thankful for the patients and healthcare professionals who continue to participate in our clinical trial program.”
Voyxact (sibeprenlimab-szsi) is a lab-engineered antibody designed to block a protein called APRIL. APRIL plays a central role in the production of faulty IgA antibodies that clog and damage the kidneys in IgAN. By shutting down this protein early in the process, Voyxact aims to slow or prevent the harmful build-up that leads to kidney damage.
APRIL has quickly become one of the hottest targets in kidney-disease biotech. Major companies – including Vera Therapeutics, Novartis, Biogen and Vertex – are developing drugs that target the same pathway. The interest signals two things: a clear medical need and a significant commercial opportunity.
Voyxact is an injection taken once every four weeks that patients can administer at home. For people managing a lifelong condition, this schedule offers convenience compared with daily pills. For investors, that at-home convenience is an important differentiator in a market currently dominated by daily oral medications.
Early results from Otsuka’s global Phase 3 VISIONARY trial played a key role in the FDA’s decision. In the study, high protein levels in urine are strongly linked to future kidney failure; a drop of this size is viewed as an essential sign that the disease may be better controlled.
The trial also found that Voyxact was generally well-tolerated. The most common side effects were mild infections and minor injection-site reactions. Most of these issues cleared up without patients needing to stop therapy. Taken together, the results paint a promising picture for long-term use and position Otsuka slightly ahead of competitors developing similar treatments.
Because the approval is accelerated, Otsuka must confirm whether Voyxact can actually slow kidney function decline over time. The company is continuing the VISIONARY trial to track changes in estimated glomerular filtration rate (eGFR) over 24 months. Results are expected in early 2026.
IgAN affects an estimated 130,000 people in the US [2]. Most are diagnosed in early adulthood, and many face the long-term risk of end-stage kidney disease requiring dialysis or transplantation. Even with standard care – ACE inhibitors, ARBs and SGLT2 inhibitors – disease progression persists.
IgAN’s early onset masks a reality that becomes more apparent with age: its consequences unfold over decades, and as kidney resilience naturally declines, long-standing inflammation can drive a steeper trajectory toward reduced function, placing additional emphasis on therapies that intervene earlier in the disease course and making effective disease modification an important consideration for aging populations and for health systems preparing for rising rates of chronic kidney impairment.
This unmet need has drawn major biotech interest. Besides Otsuka and Vera, drugmakers including Vertex and Novartis have IgAN programs in development. The entry of therapies that target APRIL marks a shift toward more precise, mechanism-based interventions.
For Otsuka, a company with a long history in kidney and rare disease therapeutics, the approval helps reinforce its strategic footprint in immunology and nephrology. It also revitalizes an asset first acquired through the 2018 purchase of Visterra.
“The availability of Voyxact represents a novel targeted approach to help manage this complex disease for patients living with IgAN,” Kraus said.
Patient groups echoed this sentiment. “We’re thrilled to hear the news about the accelerated approval of VOYXACT. It’s important for patients who are managing IgAN to have new treatment options,” said Bonnie and Ed Schneider, co-founders of the IgA Nephropathy Foundation.
Voyxact’s approval sets the pace in a crowded race to reshape IgAN treatment. Strong early efficacy, solid tolerability and at-home dosing give Otsuka a clear head start. Still, the real verdict comes in 2026, when long-term kidney function data reveal whether the drug can truly alter the course of disease.
For now, Voyxact is the frontrunner, but in a fast-moving field, momentum is only as good as the data that follow.
[1] https://www.businesswire.com/news/home/20251125491375/en/Otsuka-Receives-FDA-Accelerated-Approval-for-VOYXACT-sibeprenlimab-szsi-for-the-Reduction-of-Proteinuria-in-Adults-with-Primary-Immunoglobulin-A-Nephropathy-IgAN-at-Risk-for-Disease-Progression
[2] https://www.nature.com/articles/d43747-021-00165-0
