Efficacy and Safety of Low- to Medium-Dose Telitacicept in Adults with High-Risk Progressive IgA Nephropathy: A Retrospective Real-World Study

 

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https://storage.unitedwebnetwork.com/files/1099/cd31bcb5932dee20e1e3b5700e763b53.pdf
Efficacy and Safety of Low- to Medium-Dose Telitacicept in Adults with High-Risk Progressive IgA Nephropathy: A Retrospective Real-World Study

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Juan
Pei
Juan Pei 8199399@qq.com Department of Nephrology The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen China *
Xiuhua Xu 625254582@qq.com Department of Nephrology The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen China -
Leping Shao lepingshao@163.com Department of Nephrology The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen China -
Yinan Li liyinanxm@126.com Department of Nephrology The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen China -
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The purpose of this study was to evaluate the efficacy and safety of low- to medium-dose (160mg/W or 80mg/W) of telitacicept in adults at high risk of progression to IgA nephropathy.

This was a single-center retrospective study. The study included adults at high risk for progression of IgA nephropathy who were treated with telitacicept between November 2022 and April 2024 and followed for at least 24 weeks. 

A total of 11 patients were included. 24-h urinary protein levels significantly reduced from 1.65 ± 0.78 g/day at baseline to 0.60±0.40 g/day after 24 weeks of treatment, with a 64.38% decline (IQR, 55.56%, 73.21%, p<0.001). Similar trend observed in the telitacicept 80mg group at 24 weeks with a 68.67% decline (IQR, 53.83%, 85.51%, p<0.001), and with a 59.24% decline (IQR, 45.61%, 72.88%, p<0.001) in the telitacicept 160mg group. The level of eGFR significantly improved from 67.59 ± 29.23 ml/min/1.73 m2 to 78.59 ± 24.46 ml/min/1.73 m2 after 24 weeks of treatment, with a 23.18% increase (IQR, 8.60%, 37.76%, P =0.005). In telitacicept 80mg group, the level of eGFR increased from 54.82± 16.96 ml/min/1.73 m2 to 71.54±21.66 ml/min/1.73 m2, with a 32.72% increase (IQR, 15.58%, 49.85%, p=0.004). In telitacicept 160mg group, the level of eGFR remained stable from 82.92± 35.19 ml/min/1.73 m2 to 87.06±27.30 ml/min/1.73 m2 at week 24 with a 11.73% increase (IQR, 10.43%, 23.32%, p=0.324). The urinary RBC count decreased from 121.60 cells/μl (IQR 62,00–641.30) to 34.60 cells/μl (IQR 22.20–55.10) at week 24(P = .003). In 80mg group, the urinary RBC count decreased from 424.55 cells/μl (IQR 70.10–1403.60) to 33.30 cells/μl (IQR 13.53–160.63) at week 24 (P = .028). In 160mg group, the urinary RBC count decreased from 87.20 cells/μl (IQR 54.90–372.95) to 38.60 cells/μl (IQR 23.70–49.15) at week 24 (P = .043). The total effective rate was 90.91%, the complete remission was 27.27%, and the partial remission was 63.64%.) There were no SAEs were observed. In the whole telitacicept group, only 2 patients in 160mg telitacicept subgroup experienced local skin reactions and the patients were well tolerated. 

In this real-world study, low- to medium-dose of telitacicept combined with conventional therapy showed good onset efficacy and safety for treating IgA patients.

Kewords