Abstract: TH-PO0458
Trajectory-Based Clustering of eGFR and Proteinuria Responses to Nefecon in IgAN: Identification of Distinct Clinical Phenotypes and Personalized Treatment Strategies
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 & Sichuan Provincial People's Hospital, Chengdu, China
- Li, Guisen, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
Background
This study aimed to identify distinct therapeutic response phenotypes using joint trajectory clustering of proteinuria and eGFR in IgAN patients treated with Nefecon.
Methods
This prospective observational study enrolled 91 IgAN patients who completed 9-month follow-up with monthly assessments of proteinuria and eGFR. A composite response score was constructed: Score = -proteinuria% change + eGFR% change from baseline. K-means clustering was applied to standardized trajectory data, with optimal cluster number (k=4) determined by elbow method.Logistic regression identified predictors of optimal response.
Results
Four distinct response phenotypes were identified: (1) Best Response (n=36): proteinuria decreased from 2.44±1.51 to 0.58±0.44 g/24h(76.2% reduction), eGFR increased from 53.76±23.37 to 61.77±23.16 mL/min/1.73m^2 (14.9% improvement); (2) Intermediate Response 1 (n=29): proteinuria decreased from 1.67±0.98 to 0.80±0.55 g/24h (52.1% reduction), eGFR declined from 55.05±27.91 to 50.87±25.24 mL/min/1.73m^2(7.6% decrease); (3) Intermediate Response 2 (n=23): proteinuria decreased from 1.63±1.21 to 1.08±0.68 g/24h（33.7% reduction）,eGFR increased from 54.62±32.54 to 56.95±36.50 mL/min/1.73m2（4.3% improvement）; (4) 3 patients (3.3%) showed poor response. No statistically significant differences in adverse event rates were observed across phenotypes (all P>0.05).
Conclusion
Joint trajectory clustering successfully identified four distinct therapeutic response phenotypes to Nefecon in IgAN. Notably, patients with higher baseline proteinuria demonstrated superior dual response. This phenotypic stratification approach enables early identification of treatment responders and non-responders, facilitating personalized therapeutic strategies in IgAN management.