Telitacicept treatment for recurrent IgA nephropathy after kidney transplantation

Immunoglobulin A nephropathy (IgAN) is frequently recurrent after kidney transplantation, posing significant challenges in management. Current treatments, including glucocorticoids and immunosuppressants, have shown limited effectiveness in treating recurrent IgAN. A phase 2 clinical trial indicated that telitacicept could reduce proteinuria in patients with primary IgAN. In this report, we conduct a retrospective analysis to assess the efficacy and safety of telitacicept in treating recurrent IgAN among kidney transplant recipients.

A retrospective cohort study was conducted from August 2023 to April 2025. Patients with biopsy-proven recurrent IgAN following kidney transplantation who were treated with telitacicept were included. Clinical data were collected from hospitalization records and outpatient follow-ups. The primary outcome was proteinuria reduction at 6 months, with extended evaluation at 12 months. Renal function changes were also observed.

Ten patients with recurrent IgAN were treated with telitacicept. After a 6-month follow-up, two patients achieved complete remission (CR), and two patients reached partial remission (PR). Furthermore, six patients (60%) experienced a reduction of over 30% in proteinuria by the end of the 6-month treatment period. At 9-month follow-up, one patient reached CR, two patients reached PR and five patients (50%) showed a reduction in proteinuria. By the 12-month follow-up, serum creatinine levels and estimated glomerular filtration rate remained stable in nine patients. Furthermore, the treatment also effectively reduced urine red blood cell counts.

Telitacicept shows promising safety and efficacy in lowering proteinuria for patients with recurrent IgAN following kidney transplantation.