BACKGROUND: IgA nephropathy (IgAN) is characterized by the mesangial deposition of IgA. Its pathogenesis is driven by increased production of galactose-deficient IgA1 (Gd-IgA1) by activated B cells. Telitacicept offers a therapeutic approach for IgAN by inhibiting B-cell activation. This study aimed to investigate the efficacy and safety of telitacicept in patients with refractory IgAN. METHODS: Our study involved 9 patients with refractory IgAN who had received corticosteroids or immune modulators for at least one year before telitacicept treatment was initiated. The patients received subcutaneous telitacicept for 12 months (160 mg every week for the first 6 months), and the dose was then tapered to 160 mg every two weeks during the following 6 months. The follow-up period included the 12 months of telitacicept therapy and 6 months after drug withdrawal. We collected the patients' laboratory data throughout the follow-up period. RESULTS: After 12 months of telitacicept therapy, all patients achieved complete remission of proteinuria, and their estimated glomerular filtration rate (eGFR) exceeded the baseline level prior to treatment. Following a 6-month drug withdrawal, all patients remained in complete remission of proteinuria, and the eGFR levels did not significantly differ from those recorded at the end of the twelfth month of therapy. At the last follow-up, six patients successfully discontinued conventional IgAN drugs. No serious adverse events were reported. CONCLUSIONS: Telitacicept effectively reduced proteinuria and improved kidney function in patients with refractory IgAN. The therapeutic benefits were maintained after the discontinuation of telitacicept.
M et al. (Sat,) studied this question.
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