The FDA granted accelerated approval to Otsuka’s sibeprenlimab (Voyxact) for adults with primary immunoglobulin A nephropathy (IgAN), based on positive interim results from the phase III Visionary trial. The antibody, which blocks APRIL to reduce proteinuria, produced statistically and clinically meaningful drops in 24‑hour urine protein-to-creatinine ratio in the nine‑ and 12‑month analyses presented at ASN Kidney Week. Otsuka reported a favorable safety profile in the 150‑patient safety set and consistent efficacy across prespecified subgroups, including patients on SGLT2 inhibitors. Voyxact is delivered subcutaneously every four weeks and is the first APRIL inhibitor approved for IgAN, creating a new targeted option for a progressive autoimmune kidney disease with limited therapies. Regulatory timing outpaced the Nov. 28 PDUFA date; approval was announced Nov. 26. The decision will reshape treatment algorithms for nephrologists managing proteinuric IgAN and prompt payors and clinics to evaluate real‑world implementation and monitoring strategies.