Historically, managing C3G relied on off-label immunosuppressive agents and corticosteroids, which offered limited disease-specific efficacy. While the recent approvals of Fabhalta and Empaveli/Aspaveli provided the first targeted options, these therapies carry significant safety warnings regarding life-threatening bacterial infections. This clinical gap has left patients and providers seeking safer, more convenient alternatives, particularly those that might eventually offer oral administration.

DelveInsight projects the C3G market across the 7MM region will grow at a 28% compound annual growth rate through 2036. Current development efforts are focused on novel mechanisms:

• Zaltenibart (Novo Nordisk/Omeros): A MASP-3 inhibitor that recently gained Rare Pediatric Disease Designation.
• KP104 (Kira Pharmaceuticals): A bifunctional biologic designed to inhibit both alternative and terminal complement pathways simultaneously.
• ARO-C3 (Arrowhead Pharmaceuticals): An RNAi therapeutic that reduces liver-derived C3 production.
• CPV-104 (Eleva): A recombinant human Factor H therapy currently undergoing clinical evaluation to clear kidney C3 deposits.

According to Aparna Thakur, project manager at DelveInsight, the absence of oral-route treatments remains a primary hurdle. As these programs advance through clinical trials, the industry is increasingly focused on balancing potent complement inhibition with improved patient safety profiles and more accessible delivery methods.