Telitacicept treatment for recurrent IgA nephropathy after kidney transplantation.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: Telitacicept shows promising safety and efficacy in lowering proteinuria for patients with recurrent IgAN following kidney transplantation.