#810 Efficacy and safety of telitacicept in IgA nephropathy: a systematic review and meta-analysis

Abstract Background and Aims IgA nephropathy is most common form of primary glomerulonephritis worldwide. Current treatment options include supportive therapy, including blood pressure control, renin-angiotensin system inhibitors, lifestyle changes, and steroids for high-risk patients. Telitacicept, a dual-target fusion protein, inhibits B cell maturation and differentiation by targeting B lymphocyte Stimulator (BLyS) and A Proliferation-Inducing Ligand (APRIL). We aim to perform a systematic review and meta-analysis to evaluate the efficacy and safety of Telitacicept in patients with IgA nephropathy. Method PubMed, Cochrane Central, and Embase databases were searched from inception till 25 December 2024 for studies that compared Telitacicept with placebo or standard therapy in IgA nephropathy patients. We computed mean difference (MD) for continuous outcomes and odds ratio (OR) for binary outcomes, with 95% confidence intervals (CIs) based on random effects model. Heterogeneity was assessed using Higgins’ I² statistic, and statistical analyses were performed using Review Manager 5.4.1. The results were represented in forest plots. Results Three studies including a phase II randomised controlled trial (RCT), with a total of 162 patients were analysed. Of these, 97 (59.8%) received Telitacicept, and 65 (40.2%) received placebo or standard treatment. The median time from diagnosis to treatment initiation was 51.8 months. After 24 weeks of Telitacicept therapy, patients had significantly lower 24-hour proteinuria (MD: −0.51; 95% CI: −0.84, −0.17; P = 0.003; I2 = 11%) (Fig. 1A). Estimated glomerular filtration rate (eGFR) remained stable between both groups (MD: −1.74; 95% CI: −13.47, −9.99; P = 0.77; I2 = 0%) (Fig. 1B), and no significant difference in adverse events was observed (OR: 0.78; 95% CI: 0.18, 3.42; P = 0.74; I2 = 69%) (Fig. 1C). Conclusion Telitacicept was associated with a significant reduction in proteinuria after 24 weeks of treatment, suggesting its potential efficacy in managing IgA nephropathy. Renal function as estimated by eGFR, and adverse events were comparable between groups, supporting the safety profile of Telitacicept. These findings suggest that Telitacicept may represent a promising therapeutic strategy for IgA nephropathy.