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Background <p>Hydroxychloroquine (HCQ) has shown potential in reducing proteinuria in IgA nephropathy (IgAN) and may facilitate glucocorticoid (GC) tapering, but its efficacy remains understudied.</p> Methods <p>In this retrospective cohort study, we analyzed 75 biopsy-confirmed IgAN patients treated with HCQ plus GC and 75 propensity score-matched controls receiving GC-only (2014–2023). The primary outcome was time to GC dose reduction to ≤ 5&#xa0;mg/day within 6 months, with end-stage renal disease (ESRD) as a competing risk. Secondary outcomes included renal prognosis (eGFR decline, proteinuria). A Fine-Gray competing risk model assessed the association between HCQ and time to GC dose reduction (≤ 5&#xa0;mg/day), with end-stage renal disease as a competing event.</p> Results <p>HCQ significantly increased the probability of tapering success (adjusted HR = 1.68, 95% CI: 1.08–2.61). The HCQ + GC group also showed improved renal outcomes, with reduced proteinuria (median reduction: 72.2% vs. 49.9%, <i>p</i> = 0.01).</p> Conclusion <p>HCQ accelerates GC tapering in IgAN, offering a potential steroid-sparing strategy.</p> Clinical trial number <p>Not applicable.</p>

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Use of hydroxychloroquine to treat patients with IgA nephropathy and time to accelerated glucocorticoid tapering

  • 期刊论文

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  • 发表日期：

    2026年1月10日

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  • Mingming Ma,
  • Qiao Luo,
  • Meifen Huang,
  • Liangmei Chen,
  • Wenxue Liang,
  • Yingxue Zhong,
  • Fanna Liu,
  • Baozhang Guan

摘要

Background

Hydroxychloroquine (HCQ) has shown potential in reducing proteinuria in IgA nephropathy (IgAN) and may facilitate glucocorticoid (GC) tapering, but its efficacy remains understudied.

Methods

In this retrospective cohort study, we analyzed 75 biopsy-confirmed IgAN patients treated with HCQ plus GC and 75 propensity score-matched controls receiving GC-only (2014–2023). The primary outcome was time to GC dose reduction to ≤ 5 mg/day within 6 months, with end-stage renal disease (ESRD) as a competing risk. Secondary outcomes included renal prognosis (eGFR decline, proteinuria). A Fine-Gray competing risk model assessed the association between HCQ and time to GC dose reduction (≤ 5 mg/day), with end-stage renal disease as a competing event.

Results

HCQ significantly increased the probability of tapering success (adjusted HR = 1.68, 95% CI: 1.08–2.61). The HCQ + GC group also showed improved renal outcomes, with reduced proteinuria (median reduction: 72.2% vs. 49.9%, p = 0.01).

Conclusion

HCQ accelerates GC tapering in IgAN, offering a potential steroid-sparing strategy.

Clinical trial number

Not applicable.