Grant: Project Grant

IgA nephropathy (IgAN) is an autoimmune disease that causes kidney failure, affecting 8,000 Canadians annually. Currently, corticosteroid treatment is used to decrease disease progression in patients with high amounts of protein in their urine. However, this treatment is suboptimal as there is a high risk of serious and life-threatening side effects and this "one size fits all" approach results in a large number of patients that are unnecessarily treated, don't respond, or are inappropriately denied treatment. Targeting treatment at those more likely to respond and who are at higher risk of disease progression has not previously been possible because there was no way to determine in which patients the disease is likely to progress. We recently led an international collaboration that developed the IgAN Prediction Tool, the first tool in the world that can successfully identify patients likely to have progressive IgAN disease, and created a globally unique dataset. The proposed project will expand on this work by developing a personalized corticosteroid treatment approach optimized for each patient, an approach that will be a world first. We will use our dataset to develop a new tool that can identify patients more likely to respond to treatment. It will be validated using an external dataset from an international randomized trial. We will then develop a model that can be applied to each patient to determine the optimal treatment decision. The model will account for the risks and benefits of corticosteroids, and each patient's risk of disease progression and likelihood of responding to treatment. The results of this project will be converted into a prototype of a mobile-app for doctors and a web-based platform for patients.