Efficacy and safety of telitacicept in treatment of Advanced IgA nephropathy

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Efficacy and safety of telitacicept in treatment of Advanced IgA nephropathy

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Co-author 1

Mengjiao Lin linmengjiao56401@163.com Zhongshan Hospital of Xiamen University Nephrology Xiamen China -

Co-author 2

Yanni Zhou zhouyannni2046@sina.com Xiamen Traditional Chineses Medicine Hospital Nephrology Xiamen China -

Co-author 3

Liangxiang Xiao liangxiangxiao@xmu.edu.cn Zhongshan Hospital of Xiamen University Nephrology Xiamen China *

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Introduction

Telitacicept is a recombinant fusion protein that combines the B lymphocyte stimulator (BLyS) receptor with an antibody, effectively inhibiting the abnormal activation of B cells and plasma cells. This mechanism significantly reduces the production of galactose-deficient IgA1 (Gd-IgA1) and subsequently decreases the deposition of immune complexes in the kidneys of IgA nephropathy (IgAN) patients. This study aims to evaluate the efficacy and safety of telitacicept in the treatment of advanced IgAN patients with CKD stage 4.

Methods

Two high-risk progression IgAN patients with heavy proteinuria confirmed by renal biopsy, with more than 50% glomerulosclerosis and tubulointerstitial fibrosis were included. Patients designated as cases 1 and 2, received telitacicept at a dose of 160 mg weekly, and were followed up over 15 months. A retrospective analysis of their clinical data was conducted. The primary endpoint was the mean percentage change in 24h urinary protein (UP) and changes in serum creatinine, eGFR, along with a detailed recording of adverse events throughout the follow-up period.

Results

The baseline clinical characteristics of the two patients are summarized in Table 1. By followed-up12th month, Patient 1 showed a 95.88% decrease in 24h UP from baseline, while Patient 2 exhibited a 98.00% reduction in 24h UP. Both patients’ renal function improved and the telitacicept dose was reduced to 80mg every 2 weeks. At the 15-month follow-up, Patient 1 demonstrated a 97.71% reduction in 24h UP compared to baseline, a 94.29% decrease in urinary red blood cells, and a 33.02% reduction in serum creatinine. Patient 2, at the 15-month mark, experienced a 97.05% reduction in 24h UP, a 96.09% decrease in urinary red blood cells, and a 37.68% reduction in serum creatinine. Telitacicept dose was reduced to 80mg every 3weeks. Both patients tolerated telitacicept well, with no adverse events reported throughout the follow-up period.

Table 1

Table 2

Table 3

Conclusion

Telitacicept could be an effective and safe treatment for high-risk progression advanced IgAN patients.

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