Efficacy and Safety of Telitacicept in Adult IgA Vasculitis Nephropathy

Abstract Background To investigate the efficacy and safety of telitacicept in adult immunoglobulin A vasculitis nephritis (IgAVN) patients with persistent proteinuria. Methods This prospective single-arm study enrolled patients aged ≥ 18 years diagnosed with IgAVN, an eGFR > 60 mL/min/1.73m², previously received previous treatment with corticosteroids and immunosuppressants or had contraindications to the use of corticosteroids and immunosuppressants, and a 24-hour urinary protein creatinine ratio (UPCR) > 1 g/g. Patients received telitacicept 160 mg weekly for 6 months. Results A total of 13 patients were enrolled in this study, in which 7 patients were males. The mean age of patients was 35 years. The mean time since diagnosis before telitacicept treatment was 12.6 months. After 6 months of treatment with telitacicept, the mean 24-hour UPCR decreased from a baseline value of 2.9 ± 0.8 to 0.5 ± 0.3 g/g (P < 0.001). At 9 months, 12 patients (92.3%) achieved complete remission, the mean 24-hour UPCR decreased to 0.4 ± 0.1 g/g. Additionally, the renal function of patients remained stable, urinary red blood cells, blood CD4+ T cells, CD19+ B cells, Immunoglobulin levels were decreased compared with the baseline values in all patients at 9 months (P < 0.05). No severe adverse events were observed. Conclusion Additional telitacicept significantly increased the complete remission rate of IgAVN with persistent proteinuria and stabilized renal function, without serious adverse events.