Abstract: FR-OR070
Efficacy and Safety of Telitacicept in IgAN with Crescents
Session Information
- New IgAN Therapies: Subgroups, Outcomes, and Biomarkers
October 23, 2026 | Location: Room 501, Convention Center
Abstract Time: 05:30 PM - 05:40 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Feng, Jiayan, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China
- Cui, Chu miao, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China
- Li, Yutian, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China
- Li, Lujie, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China
- Yang, Hongze, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China
- Liu, Dajun, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China
- Bian, Xiaohui, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China
- Yun, Yang, Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning, China
Background
IgA nephropathy with crescents (IgAN-C, crescents＜50%) is frequently underappreciated despite poor renal outcomes. Immunosuppression remains controversial due to efficacy-toxicity concerns. Telitacicept (TACI-Fc, inhibiting BAFF/APRIL) safely reduced proteinuria in a phase II IgAN trial, but crescent severity was not assessed. Thus, we conducted a real-world study of telitacicept in IgAN-C.
Methods
Retrospective analysis of 154 IgAN-C patients (Jan 2022–Dec 2024, Shengjing Hospital Affiliated to China Medical University). All received maximally tolerated RASi/SGLT2i. Based on this, patients were divided into: telitacicept group, immunosuppressive group, and supportive group.
Results
Telitacicept significantly reduced 24h-Upro compared with supportive therapy (weeks 24–48) and immunosuppressive therapy (weeks 12–48, all P<0.05). It also reduced hematuria compared with supportive therapy (weeks 12–48, all P<0.05). Both telitacicept and immunosuppressive therapies attenuated the eGFR decline compared with supportive therapy at all follow-ups (Fig. 1).
Telitacicept improved both ORR and CR compared with other groups (all P < 0.01) with a higher proportion achieving the composite favorable renal endpoint (Fig.2). Multivariate logistic regression identified telitacicept as an independent predictor of ORR at week 48(Table).
Conclusion
In patients with IgAN-C, telitacicept significantly reduced proteinuria and hematuria and attenuated eGFR decline compared with immunosuppressive and supportive therapies, with no severe AEs. These preliminary real-world findings support telitacicept as a promising treatment for IgAN-C.
Logistic regression of telitacicept treatment and proteinuria decrease.
| n（%） | Model 1 OR (95%CI) | Model 2 OR (95%CI) | Model 3 OR (95%CI) | Model 4 OR (95%CI) | |
| Week 48 | |||||
| Telitacicept treatment | 85.71 | 6.00 (2.13, 16.92) | 6.16 (2.17, 17.49) | 6.38 (2.23, 18.26) | 6.38 (2.23, 18.26) |
| Immunosuppressive treatment | 50.00 | Reference | Reference | Reference | Reference |
| P | ＜0.001 | ＜0.001 | ＜0.001 | ＜0.001 |
Proteinuria decrease: >50% drop. Model 1: univariate logistic; Model 2: age/sex-adjusted; Model 3: adjusted for baseline eGFR (binary at 50 ml/min/1.73m^2); Model 4: adjusted for baseline proteinuria (binary at 1.5 g/d).