Telitacicept plus low-dose mycophenolate mofetil in the treatment of IgA nephropathy: a retrospective study

Presently, no specific therapies have been recognized for immunoglobulin A nephropathy (IgAN). Mycophenolate mofetil (MMF) has been verified effective for Chinese patients with IgAN. Telitacicept is a full-human TACI-FC fusion preventing B cells maturation and activation, and it has been proven to be beneficial for IgAN in a phase II clinical trial. This study was designed to observe the efficacy and safety of telitacicept plus low-dose MMF for IgAN treatment. This retrospective cohort study included 24 patients with IgAN, and patients were treated with telitacicept plus MMF. The primary outcome was settled as the changing in proteinuria and estimated glomerular filtration rate (eGFR). The subordinate outcome was set as the changing in hematuria. The mean follow-up time was 23 months. The median baseline proteinuria was 2.5 (1.74, 6.58) g/d, and eGFR was 94.97 (56.8, 120.67) mL/min/1.73 m². There were noteworthy reductions in proteinuria at 3, 6, 9, 12, 15, 18, 21 and 24 months when compared to the baseline levels [1.45 (0.78, 1.8) g/d [p = 0.0122], 0.505 (0.26, 0.99) g/d [p < 0.0001], 0.48 (0.28, 0.76) g/d [p < 0.0001], 0.3 (0.17, 0.85) g/d [p < 0.0001], 0.23 (0.18, 0.575) g/d [p < 0.0001], 0.18 (0.12, 0.325) g/d [p < 0.0001], 0.14 (0.105, 0.22) g/d [p < 0.0001] and 0.14 (0.103, 0.278) g/d [p < 0.0001]]. All patients maintained stable eGFR during follow-up times. Besides, telitacicept plus MMF remarkably alleviated the hematuria. Telitacicept plus MMF treatment led to not only remarkable clinically significant reduction in proteinuria and hematuria, but also stable serum creatinine value of patients with IgAN without adverse side effects.