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The Efficacy and Safety of Telitacicept versus the Recommended Regimens in IgA Nephropathy: A Single-Center
Xueting Li1, Yinghui Zhang1, Chenyun Xu1
1Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China.
Background:
IgA nephropathy (IgAN) is one of the leading causes of end-stage renal disease (ESRD). Telitacicept has been demonstrated significant efficacy in IgAN, but its comparative efficacy versus the recommended regimens in the 2025 KDIGO guideline remains unclear. The aim of this study was to investigate the clinical efficacy and safety of glucocorticoids, telitacicept, and nefecon in patients with IgAN, in order to determine the optimal treatment regimen.
Methods:
We recruited 101 patients with IgAN confirmed by renal biopsy. The patients were categorized into three groups according to the treatment they received: the GC group, the Telitacicept group, and the Nefecon group. Treatment responses, including complete remission (CR) and partial remission (PR), and adverse events were compared among the three groups after 9 months of follow-up.
Results:
At the 9-month follow-up, the CR rates were 93.5%, 86.2%, and 70.7% for the GC group, Telitacicept group, and Nefecon group, respectively (p=0.035). During the follow-up, proteinuria in all three groups decreased significantly from baseline (p < 0.05), while eGFR remained stable At the 3rd, 6th, and 9th months, the median percentage reduction in proteinuria in the GC group was significantly greater than that in the Nefecon group (p<0.001; p=0.001; p<0.001). The GC group also showed greater reductions compared to the Telitacicept group (p=0.057; p=0.101; p=0.103), and the Telitacicept group also demonstrated higher proteinuria reduction rates than the Nefecon group, although neither difference was statistically significant. Furthermore, the incidence of adverse events, particularly infections, was significantly lower in the Nefecon group than in the GC group (p < 0.05).
Conclusion:
Our study confirmed that glucocorticoids have superior efficacy to nefecon, but are associated with a higher incidence of adverse events. Telitacicept offered both efficacy and safety, and can be recommended for high-risk IgAN patients who are intolerant to glucocorticoids.
