Real-world study of telitacicept in the treatment of IgA nephropathy

This is the authors' abstract. We don't add key points for this paper.

Purpose To evaluate the efficacy and safety of telitacicept for the treatment of immunoglobulin A nephropathy (IgAN). Methods This study enrolled patients with biopsy-confirmed IgAN who had 24-hour proteinuria exceeded 0.75 g/day and received telitacicept treatment for at least 3 months. Using propensity score matching, patients were matched in a 1:1:1 ratio with those who received only supportive or immunosuppressive (IS) therapy (glucocorticoid with or without mycophenolate mofetil). The primary outcomes were percentage changes in 24-hour proteinuria and estimated glomerular filtration rate (eGFR) during the 12-month follow-up period. Results Each group included 24 patients. At 12 months, telitacicept reduced 24-hour proteinuria by 1.50 g/day (57.61%) from baseline, while the supportive treatment group had a reduction of 0.60 g/day (17.11%) and the IS treatment group had a reduction of 1.60 g/day (59.49%). The percentage change in 24-hour proteinuria in the telitacicept group was similar to that in the IS treatment group, and both groups were superior to the supportive treatment group. The telitacicept group exhibited a minor decline in eGFR of 2.1 mL/min/1.73 m 2 (−4.23%), while the supportive treatment group and IS therapy group showed declines of 6.05 mL/min/1.73 m 2 (−13.87%) and 2.65 mL/min/1.73 m 2 (−5.65%), respectively. The incidence of adverse events was lower in the telitacicept group than that in the IS treatment group. Meanwhile, there was no statistical difference in the remission rates (including complete remission and partial remission) between the telitacicept and IS treatment groups, and both groups were superior to the supportive treatment group. Conclusion Telitacicept can reduce 24-hour proteinuria in patients with IgAN and stabilize eGFR with good safety during follow-up. These findings suggest that telitacicept may represent a safer and effective therapeutic alternative to conventional IS regimens for reducing proteinuria and preserving renal function in patients with IgAN, particularly those at high risk of disease progression.