Abstract: TH-PO0499
Efficacy and Safety of Nefecon in CKD Stage 3-4 IgAN: A Retrospective 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
- Lou, Fangfang, The First People's Hospital of Foshan, Foshan, China
- Liu, Xiaoyi, The First People's Hospital of Foshan, Foshan, China
- Zhang, Zhe, The First People's Hospital of Foshan, Foshan, China
- Wu, Cuixia, The First People's Hospital of Foshan, Foshan, China
- Xie, Chao, The First People's Hospital of Foshan, Foshan, China
Background
IgA nephropathy (IgAN) is a leading cause of end-stage renal disease (ESRD), and patients with stage 3-4 chronic kidney disease (CKD) are at particularly high risk of progression. Targeted-release budesonide (Nefecon) is recommended by the 2025 KDIGO IgAN guideline for patients at risk of progressive kidney function loss, yet real-world data in Chinese patients with CKD stage 3-4 are limited.
Methods
We conducted a single-center retrospective study at The First People’s Hospital of Foshan. IgAN patients with CKD stage 3-4 who received Nefecon for >3 months and had at least one post-baseline evaluation were included. Demographics, 24-hour urinary protein, eGFR, and treatment-related adverse events were collected.
Results
Seventeen patients met the criteria from June 1, 2024 to April 29, 2025 with a mean follow-up time of 250.5±30.5 days. The mean age was 38.4±11.7 years; 9 patients were male (52.9%). Most had hypertension (82.4%). Concomitant therapies included RAAS inhibitors (64.7%), SGLT2 inhibitors (35.3%), hydroxychloroquine (52.9%), glucocorticoids (17.6%), and other immunosuppressants (23.5%). Median baseline 24-hour urinary protein was 2.0 (1.0, 2.3) g, and mean baseline eGFR was 37.5±12.8 mL/min/1.73m^2.
Compared with baseline, median 24-hour urinary protein decreased significantly at 3 months [1.5 (0.7, 2.3) g; P=0.039], 6 months [0.9 (0.7, 1.8) g; P=0.004], and 9 months [0.6 (0.4, 1.7) g; P=0.033], corresponding to approximately 25%, 55%, and 70% reductions. Mean eGFR increased at 3 months (43.0±19.3 mL/min/1.73m^2; P=0.011), 6 months (44.2±22.0 mL/min/1.73m^2; P=0.025), and 9 months (44.8±21.5 mL/min/1.73m^2; P=0.044), with an absolute increase of 7.3 mL/min/1.73m^2 at 9 months.
Common treatment-related adverse events included moon face in 7 patients (41.2%), acne in 6 (35.3%), elevated blood pressure in 3 (17.6%), and menstrual irregularity in 1 female patient. No severe adverse events were reported.
Conclusion
In this real-world cohort of IgAN patients with CKD stage 3-4, Nefecon was associated with a clinically meaningful reduction in proteinuria and an increase in eGFR over 9 months, which may translate into slower progression toward ESRD in this high-risk population.