Abstract: FR-OR068
Extended Nefecon Therapy for Residual Proteinuria in Primary IgAN: A Propensity Score-Matched Real-World Study
Session Information
- New IgAN Therapies: Subgroups, Outcomes, and Biomarkers
October 23, 2026 | Location: Room 501, Convention Center
Abstract Time: 05:10 PM - 05:20 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Tian, Gui-qing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Tu, Yuchi, Augusta University, Augusta, Georgia, United States
- Yao, Lijun, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Background
Residual proteinuria frequently persists after the standard 9-month course of targeted-release budesonide (Nefecon) in primary IgA nephropathy (IgAN). Whether extending treatment provides additional benefit remains uncertain.
Methods
We performed a retrospective single-center study of biopsy-proven primary IgAN patients who completed standard Nefecon therapy and were followed to month 15. Patients who continued Nefecon for 6 additional months were compared with those who stopped at month 9. Propensity score matching (1:2) used age, sex, serum creatinine, eGFR, and 24-hour proteinuria. Outcomes were change in proteinuria and eGFR from baseline to month 15, plus safety.
Results
After matching, 30 patients in the extended-treatment group and 60 in the standard-treatment group were analyzed, with balanced baseline characteristics. Extended treatment produced a greater reduction in proteinuria at month 15 than standard treatment (-58.2% vs. -32.7%; P=0.006). Kidney function was also better preserved, with a mean eGFR change of +2.2 vs. -2.6 mL/min/1.73 m^2 (P=0.018). Proteinuria remission occurred more often with extended therapy (73.3% vs. 58.3%; P=0.028). Adverse events were comparable between groups (36.7% vs. 30.0%; P=0.52), predominantly mild, and no severe infections, treatment-related hospitalizations, or discontinuations occurred.
Conclusion
In this propensity score–matched real-world cohort, extending Nefecon beyond 9 months was associated with additional proteinuria reduction, better preservation of kidney function, and no detectable safety penalty in patients with residual proteinuria after standard therapy.