Telitacicept versus mycophenolate mofetil in IgA nephropathy: a real-world comparative study of efficacy, renal outcomes and safety

作者：Yangyang He, Shasha Chen, Kaixiang Liu, Xirong Wu, Min Yu, Wei Wang, Kun Peng, Li Wang, Guisen Li, Xisheng Xie, Wei Qin, Xiang Zhong · 发表于：Clinical Kidney Journal · 年份：2025 · DOI：10.1093/ckj/sfaf261 · 被引用次数：10 · 研究领域：Renal Diseases and Glomerulopathies、Renal Transplantation Outcomes and Treatments、Vasculitis and related conditions

ABSTRACT Background This study aimed to evaluate the efficacy and safety of telitacicept versus mycophenolate mofetil (MMF) in high-risk progressive immunoglobulin A nephropathy (IgAN). Methods This retrospective, multicentre cohort study included patients with high-risk progressive IgAN who received telitacicept or MMF therapy, both combined with low-dose steroids. Clinical data were collected from treatment initiation to 12 months. Results A total of 104 patients were included, with 56 receiving MMF and 48 receiving telitacicept. The average age was 36.9 ± 11.8 years. Baseline characteristics were well balanced between groups, except for serum albumin, uric acid and tubular pathology based on the Oxford classification, which showed significant differences. At 12 months, telitacicept plus low-dose steroids demonstrated superior proteinuria reduction (−62.5% versus −52.9%, P = .041) and stabilized renal function (4.1% improvement in estimated glomerular filtration rate versus 5.3% decline with MMF, P = .085). Telitacicept plus low-dose steroids achieved higher complete remission rates (33.3% versus 16.1%; P = .04) and significantly lower non-response rates (29.2% versus 48.2%, P = .048) compared with MMF plus low-dose steroids. Cumulative remission rates (complete + partial) favoured telitacicept at all time points, with the largest difference at 12 months. Notably, telitacicept required substantially lower cumulative glucocorticoid doses (P < .001) and exhibited a sup...