Abstract: TH-PO0507
Early Initiation Benefits of Nefecon in IgAN: A Real-World Study
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
- Yin, Shiwei, Guiqian International Hospital, Guiyang, Guizhou, China
- Fu, Zhongwei, Guiqian International Hospital, Guiyang, Guizhou, China
Background
Nefecon (targeted-release budesonide) has been approved for the treatment of IgA nephropathy (IgAN). However, real-world evidence in Chinese patients—particularly regarding the optimal timing of initiation after biopsy—remains limited.
Methods
We conducted a retrospective analysis of 18 biopsy-confirmed IgAN patients treated with Nefecon (16 mg/day) for 12 months. Patients were stratified by biopsy-to-treatment interval (≤6 vs >6 months). Patients received either Nefecon monotherapy(n=5) or Nefecon combined with immunosuppressants(n=13). The primary endpoint was the change in 24-hour proteinuria. Complete remission was defined as proteinuria <0.5 g/d; partial remission was defined as a ≥50% reduction.
Results
Among 14 patients with complete proteinuria data, those who initiated Nefecon within 6 months after biopsy achieved a greater reduction in proteinuria than those who initiated treatment after 6 months (p=0.049), suggesting that earlier initiation after diagnosis may be associated with greater clinical benefit. At 12 months, At 12 months, the mean proteinuria in all 18 patients decreased by 45.3% from baseline to 0.72g/day (baseline: 1.31g/day; range 0.27–4.72; median 0.85). eGFR remained stable (61.7 to 65.6 mL/min/1.73 m^2).
In addition, 10 of 18 patients received a combination regimen of Nefecon and tacrolimus. As both agents are metabolized through CYP3A4 pathway, we monitored safety closely and no clinically significant adverse events were noted.
Conclusion
In this real-world Chinese cohort, early initiation (≤6 months post-biopsy) was associated with greater proteinuria reduction, supporting the clinical benefit of timely Nefecon treatment after diagnosis. The study also provides real-world safety data on concomitant use of Nefecon and tacrolimus. These findings extend evidence from NefIgArd to more diverse real-world settings.