CORRELATION BETWEEN THE EFFICACY OF TELITACICEPT AND SERUM LEVELS OF BAFF, APRIL and Gd-IgA1 IN PATIENTS WITH IgA NEPHROPATHY

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CORRELATION BETWEEN THE EFFICACY OF TELITACICEPT AND SERUM LEVELS OF BAFF, APRIL and Gd-IgA1 IN PATIENTS WITH IgA NEPHROPATHY

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Co-author 1

Jingyang Gao 1173185589@qq.com the Second Affiliated Hospital of Harbin Medical University the Department of Nephrology Harbin,Heilongjiang Province China -

Co-author 2

Xuanyi Du dxy_shennei@126.com the Second Affiliated Hospital of Harbin Medical University the Department of Nephrology Harbin,Heilongjiang Province China *

Co-author 3

Rao Fu furao_smile@hotmail.com the Second Affiliated Hospital of Harbin Medical University the Department of Nephrology Harbin,Heilongjiang Province China -

Co-author 4

Yu Zhang xiaofeiyudiu@163.com the Second Affiliated Hospital of Harbin Medical University the Department of Nephrology Harbin,Heilongjiang Province China -

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Introduction

Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide, and there remains a need for effective and safe treatment options. Telitacicept is a novel fusion protein that simultaneously inhibits BLyS and APRIL. Preliminary studies have demonstrated its significant efficacy in autoimmune diseases. However, its effectiveness and safety in the treatment of IgAN, as well as the serum biomarkers that can be used to evaluate treatment response, require further validation through real-world studies.

Methods

This retrospective, single-arm cohort study included patients with high-risk progressive IgAN who received telitacicept combined with low-dose steroids. Clinical and laboratory data were collected from treatment initiation to 12 months to assess the treatment response. Levels of BAFF, APRIL, and Gd-IgA1 were measured to analyze the relationship between the changes in these markers and proteinuria reduction.

Results

A total of 40 patients were included. At 6 months of Telitacicept treatment, urinary protein decreased by 48.23% (Z = -4.869, P < 0.001); at 12 months, it decreased by 83.11% (Z = -2.666, P = 0.008). Renal function remained stable during the follow-up period, and no serious adverse reactions were observed. Compared with healthy controls, IgAN patients had significantly higher serum levels of BAFF, APRIL, and Gd-IgA1. After 6 months of treatment, BAFF decreased by 37.19% (t = 6.141, P < 0.001), APRIL decreased by 38.56% (t = 9.927, P < 0.001), and Gd-IgA1 decreased by 63.00% (Z = 3.516, P < 0.001). Compared to BAFF (AUC = 0.590, P = 0.278) and APRIL (AUC = 0.678, P = 0.031), serum Gd-IgA1 (AUC = 0.716, P = 0.009) was more effective in evaluating clinical remission.

Conclusion

Telitacicept significantly reduces urinary protein levels in IgAN patients with a favorable safety profile during treatment. Compared to BAFF and APRIL, Gd-IgA1 shows greater value in assessing treatment response in IgAN patients.

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