Xu Lichen, Wu Shukun, Zhang Ping, Wang Fang, Di Wenjia, Zhong Shan, Hou Yifu, Yang Hongji, Li Guisen
Department of Nephrology and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Transplantation Center, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Clin Kidney J. 2025 Jul 16;18(8):sfaf232. doi: 10.1093/ckj/sfaf232. eCollection 2025 Aug.
Immunoglobulin A nephropathy (IgAN) is frequently recurrent after kidney transplantation, posing significant challenges in management. Current treatments, including glucocorticoids and immunosuppressants, have shown limited effectiveness in treating recurrent IgAN. A phase 2 clinical trial indicated that telitacicept could reduce proteinuria in patients with primary IgAN. In this report, we conduct a retrospective analysis to assess the efficacy and safety of telitacicept in treating recurrent IgAN among kidney transplant recipients.
A retrospective cohort study was conducted from August 2023 to April 2025. Patients with biopsy-proven recurrent IgAN following kidney transplantation who were treated with telitacicept were included. Clinical data were collected from hospitalization records and outpatient follow-ups. The primary outcome was proteinuria reduction at 6 months, with extended evaluation at 12 months. Renal function changes were also observed.
Ten patients with recurrent IgAN were treated with telitacicept. After a 6-month follow-up, two patients achieved complete remission (CR), and two patients reached partial remission (PR). Furthermore, six patients (60%) experienced a reduction of over 30% in proteinuria by the end of the 6-month treatment period. At 9-month follow-up, one patient reached CR, two patients reached PR and five patients (50%) showed a reduction in proteinuria. By the 12-month follow-up, serum creatinine levels and estimated glomerular filtration rate remained stable in nine patients. Furthermore, the treatment also effectively reduced urine red blood cell counts.
Telitacicept shows promising safety and efficacy in lowering proteinuria for patients with recurrent IgAN following kidney transplantation.
免疫球蛋白A肾病（IgAN）在肾移植后常复发，给治疗带来重大挑战。目前的治疗方法，包括糖皮质激素和免疫抑制剂，在治疗复发性IgAN方面效果有限。一项2期临床试验表明，泰吉华单抗可降低原发性IgAN患者的蛋白尿。在本报告中，我们进行了一项回顾性分析，以评估泰吉华单抗在治疗肾移植受者复发性IgAN中的疗效和安全性。
从2023年8月至2025年4月进行了一项回顾性队列研究。纳入肾移植后经活检证实为复发性IgAN且接受泰吉华单抗治疗的患者。临床数据从住院记录和门诊随访中收集。主要结局是6个月时蛋白尿减少，并在12个月时进行延长评估。还观察了肾功能变化。
10例复发性IgAN患者接受了泰吉华单抗治疗。经过6个月的随访，2例患者达到完全缓解（CR），2例患者达到部分缓解（PR）。此外，6例患者（60%）在6个月治疗期结束时蛋白尿减少超过30%。在9个月的随访中，1例患者达到CR，2例患者达到PR，5例患者（50%）蛋白尿减少。到12个月随访时，9例患者的血清肌酐水平和估计肾小球滤过率保持稳定。此外，该治疗还有效降低了尿红细胞计数。
泰吉华单抗在降低肾移植后复发性IgAN患者蛋白尿方面显示出有前景的安全性和疗效。
