Evidence map›Paper›PMID 41840527›Full record

ArticleBMC nephrology2026

Efficacy and safety of supportive and immunosuppressive therapies in the treatment of lgA nephropathy: a network Meta-analysis of randomized clinical trials.

Xintong Wu, Yangyang He, Huaijue Qiu, Guisen Li, Song Ren, Xiang Zhong

Abstract readNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Xintong WuSchool of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, 610054, China.
Yangyang HeDepartment of Nephrology and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, 610072, China.
Huaijue QiuSchool of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, 610054, China.
Guisen LiDepartment of Nephrology and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, 610072, China.
Song RenDepartment of Nephrology and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, 610072, China. rensongchina@126.com.
Xiang ZhongDepartment of Nephrology and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, 610072, China. zhongxiang@uestc.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIgA nephropathy has a poor prognosis. This network meta-analysis aims to evaluate the efficacy and safety of all currently available drugs comprehensively and systematically for the treatment of IgA nephropathy.

methodsWe searched MEDLINE, EMBASE, Cochrane Library until Nov 15, 2024. Primary outcomes were 24-hour proteinuria and UPCR; secondary included ESRD, doubling serum creatinine (SCr), and adverse events (AEs). Bayesian analysis provided RRs and SUCRA rankings.

resultsAnalyzing 37 RCTs (4889 patients) with 15 interventions: For reducing 24-hour proteinuria, AZA+CTX ranked highest (SUCRA 95.8%), superior to systemic corticosteroids (45.2%), other immunosuppressants (CsA 82.1%, MMF 72.1%, AZA 43.9%, CTX 21.0%), BAFF/APRIL inhibitors (63.6%), HCQ (62.9%), and RASi (16.4%). For UPCR reduction, BAFF/APRIL inhibitors (91.3%) and ERA (74.2%) outperformed systemic corticosteroids (46.8%), other immunosuppressants (MMF 74.0%, AZA+CTX 68.2%, TAC 43.8%), and TRF-budesonide (65.5%). Regarding renal protection, LEF (doubling SCr: 92.6%; ESRD: 79.1%) and systemic corticosteroids (doubling SCr: 77.0%; ESRD: 72.6%) were effective for both endpoints. For ESRD risk reduction, SGLT2i ranked second (77.0%), followed by TRF-budesonide (58.4%), with AZA+CTX being least favorable (5.5%). Safety analysis showed higher AE/SAE risks with CTX/AZA+CTX; TRF-budesonide had the next highest SAE ranks, though inter-group differences were non-significant.

conclusionAZA+CTX was associated with an effective reduction in 24-hour proteinuria in small RCTs, but it also increased the risk of renal failure progression and had poor safety. Systemic corticosteroids and TRF-budesonide balanced proteinuria reduction with slowing renal failure, though SAE vigilance is needed. Among new agents, BAFF/APRIL inhibitors and ERA excelled at UPCR reduction with favorable safety. In supportive care, SGLT2i significantly reduced CKD progression risk while maintaining a favorable safety profile.

trial registrationCRD42024582600

Indexed as

Glomerulonephritis, IGAImmunosuppressive AgentsAdrenal Cortex HormonesHumansProteinuriaRandomized Controlled Trials as TopicTreatment OutcomeAdrenal Cortex HormonesImmunosuppressive AgentsEfficacyIgA nephropathyNetwork meta-analysisSafety

Identifiers

PMID41840527
PMCPMC13104317

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.