Comparative effectiveness of budesonide EC and telitacicept in proteinuria and eGFR trajectories in IgA nephropathy: a retrospective cohort study - Report - MDSpire

Comparative effectiveness of budesonide EC and telitacicept in proteinuria and eGFR trajectories in IgA nephropathy: a retrospective cohort study

  • By

  • Xingsheng Zuo

  • Yaqin Wang

  • Fangfang Ma

  • Xianyuan Zhu

  • Chenglong Zhao

  • May 13, 2026

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Efficacy Comparison of Budesonide EC versus Telitacicept in IgA Nephropathy

Overview

This study compares the efficacy of budesonide enteric-coated (EC) capsules and telitacicept in reducing proteinuria and preserving renal function in patients with IgA nephropathy (IgAN). Results indicate that telitacicept may offer greater benefits for patients with mild-to-moderate proteinuria, while budesonide EC showed a higher average eGFR during follow-up in the primary analysis.

Background

IgA nephropathy is the most common form of primary glomerulonephritis and a leading cause of end-stage renal disease worldwide. Current treatments have limitations, and there is a need for effective therapies that can reduce proteinuria and preserve kidney function. This study addresses the lack of direct comparative data between two novel treatments, budesonide EC and telitacicept, which could inform clinical decision-making.

Data Highlights

TreatmentProteinuria ReductioneGFR Change
Budesonide ECHigher average eGFR (β = 4.090 mL/min/1.73 m²; p = 0.018)Lost significance in matched cohort (β = 5.022 mL/min/1.73 m²; p = 0.085)
TelitaciceptMore pronounced reduction in mild-to-moderate baseline proteinuria (interaction P = 0.003)Significant in propensity score-matched analysis (p = 0.003)

Key Findings

  • IgA nephropathy is the leading cause of end-stage renal disease globally.
  • Budesonide EC showed a higher average eGFR during follow-up compared to telitacicept in the primary analysis.
  • Telitacicept demonstrated a greater reduction in proteinuria for patients with mild-to-moderate baseline levels.
  • The differences in eGFR between treatments diminished after propensity score matching.
  • Initial proteinuria levels significantly influenced treatment outcomes.

Clinical Implications

Detail specific considerations for clinicians based on initial proteinuria levels.

Conclusion

This study highlights the importance of individualized treatment approaches in IgA nephropathy, emphasizing the need for further prospective studies to validate these findings.

References

  1. Clinical Rheumatology, 2022 -- Impact of Anti-TNF Therapy on Kidney Function in Individuals with Ankylosing Spondylitis
  2. Frontiers in Medicine, 2026 -- Efficacy of SGLT2 inhibitors in preventing end-stage kidney disease in patients with IgA nephropathy
  3. Frontiers in Immunology, 2026 -- Recurrence of IgA nephropathy in a kidney transplant patient successfully treated with iptacopan
  4. KDIGO 2025 Clinical Practice Guideline for the Management of IgAN
  5. ScienceDirect, 2023 -- Efficacy and safety of a targeted-release formulation of budesonide in patients with primary IgA nephropathy
  6. PubMed -- Randomized Phase 2 Trial of Telitacicept in Patients With IgA Nephropathy
  7. Bone Marrow Transplantation — Comparison of ECP and ruxolitinib for managing steroid-refractory chronic GVHD: A retrospective analysis by the EBMT transplant complications working group
  8. Executive summary of the KDIGO 2025 Clinical Practice Guideline for the Management of Immunoglobulin A Nephropathy (IgAN) and Immunoglobulin A Vasculitis (IgAV)
  9. Efficacy and safety of a targeted-release formulation of budesonide in patients with primary IgA nephropathy (NefIgArd): 2-year results from a randomised phase 3 trial - ScienceDirect
  10. Randomized Phase 2 Trial of Telitacicept in Patients With IgA Nephropathy With Persistent Proteinuria - PubMed

Original Source(s)

Comparative effectiveness of budesonide EC and telitacicept in proteinuria and eGFR trajectories in IgA nephropathy: a retrospective cohort study

  • by Xingsheng Zuo, Yaqin Wang, Fangfang Ma, Xianyuan Zhu, Chenglong Zhao

  • May 13, 2026

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