Jiayi Li, Hongqin Tai, Bo Yang, Jiayu Xu, Chenchen Zhou, Jing Xu, Cheng Xue, Zhiguo Mao
{"title":"Efficacy and safety of TRF-budesonide in IgA nephropathy treatment: a meta-analysis.","authors":"Jiayi Li, Hongqin Tai, Bo Yang, Jiayu Xu, Chenchen Zhou, Jing Xu, Cheng Xue, Zhiguo Mao","doi":"10.1007/s40620-025-02341-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>IgA nephropathy (IgAN) is a common glomerular disease characterized by IgA glomerular, typically mensangial deposition, often leading to progressive kidney damage.</p><p><strong>Methods: </strong>This meta-analysis assessed the efficacy and safety of TRF-budesonide in IgAN patients, using data from four randomized controlled trials involving 774 participants. We calculated the mean differences in estimated glomerular filtration rate (eGFR) and urine-to-protein-creatinine ratio (UPCR) compared to baseline, with 95% confidence intervals (CIs) after 9 months of treatment and at the end of the follow-up period, while also summarizing adverse events.</p><p><strong>Results: </strong>TRF-budesonide significantly reduced UPCR (weighted mean difference [WMD] = - 0.39 g/g, 95% CI - 0.51, - 0.26, p < 0.00001, I<sup>2</sup> = 0%) and slowed the decline in eGFR (WMD = 5.39 ml/min/1.73 m<sup>2</sup>, 95% CI 3.68, 7.10, p < 0.00001, I<sup>2</sup> = 0%), with these effects persisting throughout the follow-up period. However, TRF-budesonide was associated with a higher incidence of adverse events such as acne (OR = 5.04, 95% CI 2.46, 10.34, p < 0.0001), facial edema (OR = 10.12, 95% CI 2.31, 44.22, p = 0.002), hypertension (OR = 4.86, 95% CI 2.40, 9.85, p < 0.0001), and muscle spasms (OR = 3.03, 95% CI 1.64, 5.60, p = 0.0004). Despite these side effects, serious systemic effects were exceptional.</p><p><strong>Conclusions: </strong>TRF-budesonide demonstrated efficacy and a tolerable safety profile in the treatment of IgAN.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1797-1808"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40620-025-02341-2","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: IgA nephropathy (IgAN) is a common glomerular disease characterized by IgA glomerular, typically mensangial deposition, often leading to progressive kidney damage.
Methods: This meta-analysis assessed the efficacy and safety of TRF-budesonide in IgAN patients, using data from four randomized controlled trials involving 774 participants. We calculated the mean differences in estimated glomerular filtration rate (eGFR) and urine-to-protein-creatinine ratio (UPCR) compared to baseline, with 95% confidence intervals (CIs) after 9 months of treatment and at the end of the follow-up period, while also summarizing adverse events.
Results: TRF-budesonide significantly reduced UPCR (weighted mean difference [WMD] = - 0.39 g/g, 95% CI - 0.51, - 0.26, p < 0.00001, I2 = 0%) and slowed the decline in eGFR (WMD = 5.39 ml/min/1.73 m2, 95% CI 3.68, 7.10, p < 0.00001, I2 = 0%), with these effects persisting throughout the follow-up period. However, TRF-budesonide was associated with a higher incidence of adverse events such as acne (OR = 5.04, 95% CI 2.46, 10.34, p < 0.0001), facial edema (OR = 10.12, 95% CI 2.31, 44.22, p = 0.002), hypertension (OR = 4.86, 95% CI 2.40, 9.85, p < 0.0001), and muscle spasms (OR = 3.03, 95% CI 1.64, 5.60, p = 0.0004). Despite these side effects, serious systemic effects were exceptional.
Conclusions: TRF-budesonide demonstrated efficacy and a tolerable safety profile in the treatment of IgAN.
期刊介绍:
Journal of Nephrology is a bimonthly journal that considers publication of peer reviewed original manuscripts dealing with both clinical and laboratory investigations of relevance to the broad fields of Nephrology, Dialysis and Transplantation. It is the Official Journal of the Italian Society of Nephrology (SIN).