Effectiveness and safety of telitacicept in recurrent IgA nephropathy after kidney transplantation

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Effectiveness and safety of telitacicept in recurrent IgA nephropathy after kidney transplantation

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Co-author 1

Shaohua Shi 3027925886@qq.com Kidney Transplantation Center The second People’s Hospital of Shanxi Province Taiyuan China *

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Introduction

Immunoglobulin A nephropathy (IgAN) is frequently recurrent after kidney transplantation, posing significant challenges in management. Telitacicept reduces B cell activation and abnormal immunoglobulin A (IgA) antibody production by inhibiting the activity of B lymphocyte stimulator (BLyS) and a proliferation-inducing ligand (APRIL), thereby decreasing IgA deposition in he glomeruli and local inflammatory response. This ultimately protects the kidneys from damage.A phase 2 clinical trial indicated that telitacicept could reduce proteinuria in patients with primary IgAN. In this report, we conduct a retrospective analysis to assess the efficacy and safety of telitacicept in treating recurrent IgAN among kidney transplant recipients.

Methods

A retrospective cohort study was conducted from April 2023 to April 2025. Patients with biopsy-proven recurrent IgAN following kidney transplantation who were treated with telitacicept were included. Clinical data were collected from hospitalization records and outpatient follow-ups. The primary outcome was proteinuria reduction at 6 months.Renal function changes were also observed.

Results

Eleven patients with recurrent IgAN were treated with telitacicept. After a 6-month follow-up, two patients achieved complete remission (CR), and five patients reached partial remission (PR).The remaining four patients were unable to continue to use telitacicept for six months due to financial reasons.By the 6-month follow-up, serum creatinine levels and estimated glomerular filtration rate remained stable in all patients. No severe adverse events were reported in all patients.

Conclusion

Our study has provided supportive evidence for the efficacy and safety of telitacicept as a viable treatment option for recurrent IgA nephropathy after kidney transplantation.

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