Aim Given the limitations of current Immunoglobulin A nephropathy (IgAN) therapies, this study sought to evaluate the short-term efficacy and safety of the novel agent Telitacicept, a dual inhibitor of B lymphocyte stimulator (BLyS) and a proliferation-inducing ligand (APRIL), in a real-world clinical setting. Methods This study employed a single-center, retrospective, self-controlled before–after design. Twelve patients with primary IgAN on stable background therapy comprising angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB) and a sodium–glucose cotransporter 2 inhibitor (SGLT2i) received add-on Telitacicept treatment for 6 months. Data on 24-h urinary protein excretion (24hUP) and estimated glomerular filtration rate (eGFR) were collected at baseline, 3 months, and 6 months. Urinary red blood cell count and safety-related indicators were collected at baseline and 6 months. Efficacy and safety were assessed by comparing intra-individual data across these time points. Results After Telitacicept treatment, 24hUP decreased at 3 and 6 months with statistical significance (p = 0.016, 0.004, respectively). The median 24hUP decreased from 1.13 g/24 h (IQR 0.62–2.24) at baseline to 0.52 g/24 h (IQR 0.26–1.33) at 3 months and was maintained at 0.51 g/24 h (IQR 0.15–1.07) at 6 months, yielding a clinical remission rate of 75.0%. Concurrently, the median eGFR increased from 61.09 mL/min/1.73 m2 at baseline to 77.44 mL/min/1.73m2 at 6 months, with statistical significance (p = 0.008), and 83.3% of patients showed renal function improvement. The median urinary red blood cell count decreased from 159.00 cells/μL to 15.00 cells/μL with statistical significance (p = 0.005), and 70.0% of patients with baseline hematuria achieved hematuria remission. The incidence of adverse events was low (4 cases), and all were mild. Non-high-density lipoprotein cholesterol (non-HDL-C) levels decreased, with statistical significance (p = 0.028), while other cardiovascular risk indicators remained stable. Conclusion Add-on Telitacicept to standard supportive care may reduce proteinuria, improve renal function, and promote hematuria remission in patients with primary IgAN, with a favorable safety profile.

Observation on the short-term efficacy of telitacicept in the treatment of primary IgA nephropathy

期刊论文
发表日期：

2026年3月23日

查看全文

Xiaoling Gu,
Chun Xu,
Yuqing Hu,
Liyun Chen,
Meng Liang

摘要

Aim

Given the limitations of current Immunoglobulin A nephropathy (IgAN) therapies, this study sought to evaluate the short-term efficacy and safety of the novel agent Telitacicept, a dual inhibitor of B lymphocyte stimulator (BLyS) and a proliferation-inducing ligand (APRIL), in a real-world clinical setting.

Methods

This study employed a single-center, retrospective, self-controlled before–after design. Twelve patients with primary IgAN on stable background therapy comprising angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB) and a sodium–glucose cotransporter 2 inhibitor (SGLT2i) received add-on Telitacicept treatment for 6 months. Data on 24-h urinary protein excretion (24hUP) and estimated glomerular filtration rate (eGFR) were collected at baseline, 3 months, and 6 months. Urinary red blood cell count and safety-related indicators were collected at baseline and 6 months. Efficacy and safety were assessed by comparing intra-individual data across these time points.

Results

After Telitacicept treatment, 24hUP decreased at 3 and 6 months with statistical significance (p = 0.016, 0.004, respectively). The median 24hUP decreased from 1.13 g/24 h (IQR 0.62–2.24) at baseline to 0.52 g/24 h (IQR 0.26–1.33) at 3 months and was maintained at 0.51 g/24 h (IQR 0.15–1.07) at 6 months, yielding a clinical remission rate of 75.0%. Concurrently, the median eGFR increased from 61.09 mL/min/1.73 m² at baseline to 77.44 mL/min/1.73m² at 6 months, with statistical significance (p = 0.008), and 83.3% of patients showed renal function improvement. The median urinary red blood cell count decreased from 159.00 cells/μL to 15.00 cells/μL with statistical significance (p = 0.005), and 70.0% of patients with baseline hematuria achieved hematuria remission. The incidence of adverse events was low (4 cases), and all were mild. Non-high-density lipoprotein cholesterol (non-HDL-C) levels decreased, with statistical significance (p = 0.028), while other cardiovascular risk indicators remained stable.

Conclusion

Add-on Telitacicept to standard supportive care may reduce proteinuria, improve renal function, and promote hematuria remission in patients with primary IgAN, with a favorable safety profile.