Efficacy And Safety Of Telitacicept Combined With Low-Dose Corticosteroids For Immunoglobulin A Vasculitis Nephropathy

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Efficacy And Safety Of Telitacicept Combined With Low-Dose Corticosteroids For Immunoglobulin A Vasculitis Nephropathy

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Co-author 1

Shi Jin jin.shi@zs-hospital.sh.cn Zhongshan hospital Fudan University Nephrology Shanghai China *

Co-author 2

Xiaoyan Jiao jiao.xiaoyan@zs-hospital.sh.cn Zhongshan hospital Fudan University Nephrology Shanghai China -

Co-author 3

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

Co-author 4

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

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Introduction

Telitacicept effectively reduced proteinuria in patients with immunoglobulin A nephropathy(IgAN) by blocking BLyS and APRIL, which are critial for B-cell survival and autoantibody production. Considering the similar pathogenesis between IgAN and IgA vasculitis nephropathy(IgAVN), we explore the efficacy of telitacicept in treating IgAVN.

Methods

A retrospective study enrolled adult IgAVN patients admitted to the Department of Nephrology at Zhongshan Hospital, Fudan University, between July 2023 and March 2025. All patients received subcutaneous injections of telitacicept (160 mg/week or 240 mg/week) combined with low-dose oral prednisone (starting dose: 0.3–0.5 mg/kg/day, maximum dose: 30 mg/day) for at least 3 months. Laboratory parameters (24-hour urinary protein, eGFR, serum albumin) and adverse events were analyzed at baseline and post-treatment.

Results

10 patients( 6 men and 4 women) with a mean age of 43 were included, with a median follow-up duration of 16 (range 12–48) weeks. At 12 weeks, 24-hour urinary protein decreased significantly from 0.95 g/d (IQR 0.79–1.90) at baseline to 0.24 g/d (0.12–0.545) (P＜0.05), with a further reduction to 0.26 g/d (0.09–1.03) at 16 weeks. Baseline eGFR (92 mL/min/1.73m², IQR 50.6–120.5) remained stable post-treatment (P＞0.05). 4 patients achieved partial remission in urine protein at a median of 7.4 weeks, while 7 patients attained complete remission at a median time of 11 weeks. Serum IgA and IgG levels demonstrated a significant decrease compared to baseline levels since 4 weeks of treatment (P＜0.05).The median prednisone dose was reduced to ＜5 mg/day by week 16. No severe adverse events were reported, with a 20% (2/10) incidence of injection-site reactions.

Conclusion

Telitacicept combined with low-dose glucocorticoids significantly reduces proteinuria in adult HSPN patients with favorable safety, though its long-term renal protective effects require validation through larger prospective trials.

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