Efficacy and Safety of Low- to Medium-Dose Telitacicept in Adults with High-Risk Progressive IgA Nephropathy: A Retrospective Real-World Study

Abstract Objective: The purpose of this study was to evaluate the efficacy and safety of low- to medium-dose (160 mg/W or 80 mg/W) telitacicept in adults at high risk of progression to IgA nephropathy. Methods: This was a single-center retrospective study. The study included adults at high risk for progression of IgA nephropathy who were treated with telitacicept between November 2022 and April 2024 and followed for at least 24 weeks. Results: In this study of 11 patients, telitacicept significantly reduced proteinuria by 64.38% (p < 0.001) and increased eGFR by 23.18% (p = 0.005) at week 24. Both the 80 mg and 160 mg dose groups demonstrated significant reductions in proteinuria (68.67% and 59.23%, respectively, both p < 0.001) and urinary RBC counts. The overall response rate was 90.91%. Telitacicept demonstrated a favorable safety profile, with only mild injection-site reactions reported (18.2%) and no serious adverse events. Conclusion: In this real-world study, low- to medium-dose of telitacicept combined with conventional therapy showed rapid onset efficacy and safety for treating high-risk progressive IgA patients.