Jiayi Li, Hongqin Tai, Bo Yang, Jiayu Xu, Chenchen Zhou, Jing Xu, Cheng Xue, Zhiguo Mao
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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":"{\"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). 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引用次数: 0
摘要
背景：IgA肾病（IgAN）是一种常见的肾小球疾病，其特征是IgA肾小球，典型的肾膜沉积，常导致进行性肾损害。方法：本荟萃分析评估了trf -布地奈德治疗IgAN患者的有效性和安全性，数据来自4项涉及774名参与者的随机对照试验。我们计算了治疗9个月后和随访结束时肾小球滤过率（eGFR）和尿-蛋白-肌酐比（UPCR）与基线相比的平均差异，95%置信区间（ci），同时也总结了不良事件。结果：trf -布地奈德显著降低UPCR（加权平均差[WMD] = - 0.39 g/g, 95% CI - 0.51, - 0.26, p 2 = 0%），减缓eGFR的下降（WMD = 5.39 ml/min/1.73 m2, 95% CI 3.68, 7.10, p 2 = 0%），这些效果持续整个随访期间。然而，trf -布地奈德与较高的不良事件发生率相关，如痤疮（OR = 5.04, 95% CI 2.46, 10.34, p）。结论：trf -布地奈德在治疗IgAN中显示出有效性和可耐受的安全性。
Efficacy and safety of TRF-budesonide in IgA nephropathy treatment: a meta-analysis.
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).
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