Wu Jingyi, Chen Pei, Liu Lijun, Shi Sufang, Wang Fang, Zhong Xuhui, Lv Jicheng, Zhang Hong
Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China.
Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.
Pediatr Nephrol. 2025 Jul 25. doi: 10.1007/s00467-025-06905-z.
IgA nephropathy (IgAN) and IgA vasculitis nephritis (IgAVN) are among the most common glomerulopathies in adolescents, yet treatment options remain limited. Telitacicept (TACI), a dual-target fusion protein, has shown therapeutic potential in adult patients. This study aimed to evaluate the efficacy and safety of telitacicept in adolescents with IgAN and IgAVN.
This retrospective observational study included 15 adolescent patients (11 with IgAN and 4 with IgAVN) who received telitacicept between January 2023 and January 2025. Patients received weekly subcutaneous injections of 80 mg or 160 mg. The primary efficacy outcome was proteinuria from baseline to follow-up. Secondary outcomes included changes in eGFR, serum albumin, and hemoglobin.
The median age of the patients was 16.91 years. After TACI treatment, the median proteinuria decreased from 2.0 g/day at baseline to 1.0 g/day at month 3 (P = 0.074) and further to 0.5 g/day at month 12 (P = 0.015), corresponding to median reductions of 31.2% and 59.0%, respectively. Median eGFR remained stable, showing an 1.1% increase at month 12 (P = 0.912). At month 12, serum albumin and hemoglobin increased by 5.6 g/L (5.8%) and 12.5 g/L (10.6%), respectively. Subgroup analyses showed consistent proteinuria reduction across baseline characteristics. Most patients tolerated telitacicept well, with no serious adverse events or treatment discontinuations reported.
Telitacicept appeared to be well-tolerated and was associated with substantial reductions in proteinuria in adolescent patients with IgAN and IgAVN. Larger studies are needed to validate these findings.
IgA肾病（IgAN）和IgA血管炎肾炎（IgAVN）是青少年中最常见的肾小球疾病，然而治疗选择仍然有限。泰吉华（TACI），一种双靶点融合蛋白，已在成年患者中显示出治疗潜力。本研究旨在评估泰吉华在青少年IgAN和IgAVN患者中的疗效和安全性。
这项回顾性观察研究纳入了15例在2023年1月至2025年1月期间接受泰吉华治疗的青少年患者（11例IgAN患者和4例IgAVN患者）。患者每周皮下注射80mg或160mg。主要疗效指标是从基线到随访期间的蛋白尿。次要指标包括估算肾小球滤过率（eGFR）、血清白蛋白和血红蛋白的变化。
患者的中位年龄为16.91岁。在TACI治疗后，蛋白尿中位数从基线时的2.0g/天降至第3个月时的1.0g/天（P = 0.074），并在第12个月进一步降至0.5g/天（P = 0.015），相应的中位数降幅分别为31.2%和59.0%。eGFR中位数保持稳定，在第12个月时增加了1.1%（P = 0.912）。在第12个月时，血清白蛋白和血红蛋白分别增加了5.6g/L（5.8%）和12.5g/L（10.6%）。亚组分析显示，不同基线特征的患者蛋白尿均有一致的降低。大多数患者对泰吉华耐受性良好，未报告严重不良事件或治疗中断情况。
泰吉华似乎耐受性良好，并且与青少年IgAN和IgAVN患者蛋白尿的大幅降低相关。需要更大规模的研究来验证这些发现。
