Efficacy and Safety Evaluation of Telitacicept in IgAN

Background: IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Telitacicept is a dual-target fusion protein that inhibits both BAFF and APRIL. This study explored the efficacy and safety of telitacicept in adult IgAN. Methods: We included biopsy-proven IgAN patients who received telitacicept treatment. The primary outcomes were the change in 24-hour proteinuria and eGFR over time. Results: A total of 62 patients were recruited. The 24-hour proteinuria reduced significantly from 2.25 (1.26, 3.16) g to 0.42 (0.26, 1.00) g at 6-month-follow-up. The level of eGFR remained stable (57 [37, 75] vs 59 [48.5, 90] mL/min/1.73m2). The patients were then divided into the glucocorticoids (GC) combined group (C group, n=45) and telitacicept alone group (A group, n=17). The baseline proteinuria level in C group was higher (2.39 g vs 1.62 g). There was a notable decrease of proteinuria at 1 month compared with baseline in C group, while the decrease was observed at 3 months in A group. No serious adverse events were recorded. Conclusion: Telitacicept may be an effective and safe treatment for IgAN. The combination of GC could reduce proteinuria more quickly.Fig. 1 Changes in proteinuria and eGFR levels during follow up. Data are expressed as median and interquartile ranges. *p<0.05.Fig. 2 Changes in proteinuria in two subgroups during follow up. Data are expressed as median and interquartile ranges. *p<0.05. A. Patients treated with telitacicept plus glucocorticoid (C group). B. Patients treated with telitacicept alone (A group).