Real-world study of telitacicept in the treatment of IgA nephropathy.

Purpose: To evaluate the efficacy and safety of telitacicept for the treatment of immunoglobulin A nephropathy (IgAN). Methods: This study enrolled patients with biopsy-confirmed IgAN who had 24-hour proteinuria exceeded 0.75 g/day and received telitacicept treatment for at least 3 months. Using propensity score matching, patients were matched in a 1:1:1 ratio with those who received only supportive or immunosuppressive (IS) therapy (glucocorticoid with or without mycophenolate mofetil). The primary outcomes were percentage changes in 24-hour proteinuria and estimated glomerular filtration rate (eGFR) during the 12-month follow-up period. Results: Each group included 24 patients. At 12 months, telitacicept reduced 24-hour proteinuria by 1.50 g/day (57.61%) from baseline, while the supportive treatment group had a reduction of 0.60 g/day (17.11%) and the IS treatment group had a reduction of 1.60 g/day (59.49%). The percentage change in 24-hour proteinuria in the telitacicept group was similar to that in the IS treatment group, and both groups were superior to the supportive treatment group. The telitacicept group exhibited a minor decline in eGFR of 2.1 mL/min/1.73 m Conclusion: Telitacicept can reduce 24-hour proteinuria in patients with IgAN and stabilize eGFR with good safety during follow-up. These findings suggest that telitacicept may represent a safer and effective therapeutic alternative to conventional IS regimens for reducing proteinuria and preserving renal function in patients with IgAN, particularly those at high risk of disease progression.