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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
IgA nephropathy (IgAN) remains the most common primary glomerulonephritis and a leading cause of kidney failure worldwide, with especially high burden in Asian populations. Despite optimized supportive care, many patients progress to end-stage kidney disease. Targeted-release budesonide (TRF-budesonide), designed to selectively modulate gut-associated immunity, offers a novel approach with reduced systemic corticosteroid exposure. Its impact on clinical outcomes and practice integration requires synthesis.
We systematically searched PubMed, PMC and Scopus for trials and observational studies evaluating TRF budesonide in adults with biopsy-proven IgAN on optimized supportive care. Outcomes included change in urinary protein-to-creatinine ratio (UPCR), estimated glomerular filtration rate (eGFR), risk of renal progression (≥30% eGFR decline or kidney failure), treatment-emergent adverse events (TEAEs), severe adverse events (SAEs), and discontinuations due to adverse events. Pooled analyses were performed using fixed- or random-effects models according to heterogeneity. Results were expressed as mean difference (MD), hazard ratio (HR), or risk ratio (RR) with 95% confidence intervals (CIs).
Six studies (four RCTs and two cohorts, 825 patients) were included in this review. Across two RCTs with multiple subgroups, TRF budesonide significantly reduced proteinuria compared with placebo (MD −19.72%, 95% CI −27.65 to −11.78; P < 0.00001). The mean change in eGFR was not significantly different between groups (MD −1.44 mL/min/1.73 m², 95% CI −7.86 to 4.99; P = 0.66). However, the risk of renal progression, defined as ≥30% eGFR decline or kidney failure, was significantly reduced with targeted-release budesonide (HR 0.42, 95% CI 0.25 to 0.70; P = 0.001). TEAEs occurred more frequently in the intervention group (RR 1.19, 95% CI 1.12 to 1.28; P < 0.00001), and discontinuations due to adverse events were also increased (RR 4.81, 95% CI 2.39 to 9.70; P < 0.0001). Severe adverse events were not significantly different between groups (P = 0.21). Two observational studies showed consistent reductions in proteinuria and stable renal function over 12 months, supporting the RCT findings in real-world settings.
TRF budesonide significantly reduces proteinuria and lowers the risk of renal function decline in IgAN patients while maintaining stable eGFR. Although TEAEs and treatment discontinuations were more common, severe adverse events were not significantly increased. These findings support TRF budesonide as an effective and generally well-tolerated therapy for IgAN, with further studies needed to optimize patient selection and long-term safety outcomes.
