Telitacicept add glucocorticoids versus telitacicept alone in the treatment of IgA nephropathy: a real-world study

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Telitacicept add glucocorticoids versus telitacicept alone in the treatment of IgA nephropathy: a real-world study

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Co-author 1

Yan Yang yangyan950710@163.com Zhongshan Hospital, Fudan University Department of Nephrology Shanghai China -

Co-author 2

Yafei Chen chen.yafei@zs-hospital.sh.cn Zhongshan Hospital, Fudan University Department of Nephrology Shanghai China -

Co-author 3

Xialian Xu xu.xialian@zs-hospital.sh.cn Zhongshan Hospital, Fudan University Department of Nephrology Shanghai China -

Co-author 4

Shi Jin jin.shi@zs-hospital.sh.cn Zhongshan Hospital, Fudan University Department of Nephrology Shanghai China -

Co-author 5

Xiaoqiang Ding ding.xiaoqiang@zs-hospital.sh.cn Zhongshan Hospital, Fudan University Department of Nephrology Shanghai China -

Co-author 6

Yiqin Shi shi.yiqin@zs-hospital.sh.cn Zhongshan Hospital, Fudan University Department of Nephrology Shanghai China -

Co-author 7

Shengzhuo You youshengzhuo2001@163.com Zhongshan Hospital, Fudan University Department of Nephrology Shanghai China *

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Telitacicept, a novel fusion protein that targets B lymphocyte stimulator and a proliferation-inducing ligand, has been used in autoimmune diseases. However, the efficacy and safety of telitacicept combined with glucocorticoids (GCs) in the treatment of immunoglobulin A nephropathy (IgAN) remain unclear.

Methods

A total of 71 IgAN patients who received telitacicept without concurrent immunosuppressive therapy were included. Among them, 40 patients who received telitacicept 160 mg weekly and had not received GCs within the previous 3 months were further analyzed. Patients treated with telitacicept alone formed the telitacicept-alone subgroup, while those who received telitacicept plus GCs formed the telitacicept + GC subgroup. The primary outcome was the change in 24-hour proteinuria from baseline over time.

Results

The telitacicept + GC subgroup showed a greater reduction in mean proteinuria (−1.93 g/day, IQR: −2.25 to −1.19) compared with the telitacicept-alone subgroup (−0.69 g/day, IQR: −1.58 to −0.42; p = 0.007) at 6 months. The eGFR slightly increased with no significant difference(4.5 vs. 3.9 ml/min/1.73 m²; p = 0.88). Both groups showed reductions in serum IgA, IgG levels, and the percentage of patients with hematuria. No serious adverse events were reported.

Conclusion

Telitacicept combined with glucocorticoids may offer a greater reduction in proteinuria than telitacicept monotherapy in IgAN patients, with preserved renal function. These findings support potential benefit of adjunctive GC therapy in selected patients undergoing telitacicept treatment.

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