Abstract: TH-PO0459
Real-World Multicenter Evidence on Nefecon for Attenuating Proteinuria and Kidney Function Decline in IgAN
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - IgAN
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Chen, Shasha, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, Sichuan, China
- Jiang, Lanping, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Li, Guisen, Sichuan Academy of Medical Sciences and Sichuan People's Hospital, Chengdu, Sichuan, China
Background
Targeted-release budesonide (Nefecon) has demonstrated efficacy in IgA nephropathy (IgAN) trials, but real-world data across disease severity remains limited.
Methods
This multicenter retrospective cohort study included 148 biopsy-proven IgAN adults (RASi +Nefecon =79; RASi =69). Primary endpoints were 9-month changes in proteinuria and eGFR.
Results
Despite worse baseline eGFR (median 54.2 vs. 85.3 mL/min/1.73m^2; P<0.001) and more severe pathological lesions in RASi +Nefecon group, Nefecon was associated with greater proteinuria reduction (–1.38 vs. –0.58 g/24h; P<0.001) and favorable eGFR trajectories (+2.69 vs. -11.2 mL/min/1.73m^2; between-group difference 13.8 mL/min/1.73m^2; P=0.032). Complete remission and partial remission rates were higher (29.1% and 48.1% vs. 10.1% and 39.1%; P<0.001), with 59.5% achieving ≥50% proteinuria reduction versus 21.7% (RR 2.70, 95% CI 1.62–4.51). Notably, 51.1% of initial non-responders achieved remission by 9 months, with complete remission rates increasing 4.6-fold over time in Nefecon group, but complete remission rate in RAS group did not show a significant improvement. Adverse events were mainly menstrual disorders, acne and moon face. Serious adverse events were rare (2.5%).
Conclusion
This real-world observational analysis shows Nefecon associated with improved proteinuria and eGFR outcomes, extending randomized trial evidence to patients with advanced CKD and revealing substantial delayed response.