Atacicept

Atacicept, sold under the brand name Trutakna, is a medication used for the treatment of proteinuria.² Atacicept was developed by Merck KGaA.³ It is given via subcutaneous injection (under the skin).⁴

Atacicept was approved for medical use in the United States in July 2026.² Atacicept is the first medication that targets both B-cell activating factor and a proliferation-inducing ligand (APRIL), which are involved in survival and maturation of certain immune cells.⁴ This in turn decreases production of the abnormal immunoglobulin A antibody.⁴

Atacicept is indicated to reduce proteinuria in adults with primary immunoglobulin A nephropathy at risk for disease progression.⁴

Immunoglobulin A nephropathy is a serious kidney disease that occurs when an abnormal form of an immunoglobulin A antibody builds up in the kidneys, causing kidney inflammation and damage.⁴ This kidney damage can cause protein to leak from the blood into the urine (proteinuria) and loss of kidney function over time that may progress to kidney failure.⁴

The protein combines the binding site for two cytokines that regulate maturation, function, and survival of B cells – B-lymphocyte stimulator (BLyS) and A proliferation-inducing ligand (APRIL), with the constant region of immunoglobin.⁵ Atacicept blocks activation of B cells by the tumor necrosis factor receptor superfamily member 13B (more commonly known as TACI), a transmembrane receptor protein found predominantly on the surface of B cells. Like the monoclonal antibody belimumab, atacicept blocks the binding of BLyS, but it also blocks APRIL. Binding of these TACI ligands induces proliferation, activation, and longevity of B cells and thus their production of autoantibodies.⁶ Atacicept is thought to selectively impair mature B cells and plasma cells with less impact on progenitor cells and memory B cells.⁷

The efficacy and safety of atacicept were evaluated in a randomized, double-blind, placebo-controlled clinical trial (NCT04716231) in adults with biopsy-confirmed IgA nephropathy.⁴ Participants were randomly assigned to either atacicept 150 mg injected subcutaneously once weekly or placebo.⁴

Atacicept was approved for medical use in the United States in July 2026.⁸ The FDA granted the application for atacicept priority review and breakthrough therapy designations. The approval of Trutakna was granted to Vera Therapeutics.⁴

Atacicept is the international nonproprietary name.⁹

Atacicept is sold under the brand name Trutakna.²