Comparative effectiveness of budesonide EC and telitacicept in proteinuria and eGFR trajectories in IgA nephropathy: a retrospective cohort study - Summary - MDSpire
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Comparative effectiveness of budesonide EC and telitacicept in proteinuria and eGFR trajectories in IgA nephropathy: a retrospective cohort study
To compare the effectiveness of budesonide EC and telitacicept in lowering proteinuria and maintaining renal function in patients with IgA nephropathy, addressing the lack of direct comparative data.
Key Findings:
Telitacicept showed a more significant reduction in proteinuria, particularly in patients with mild-to-moderate baseline proteinuria (interaction P = 0.003), indicating a potential treatment stratification based on initial levels.
Budesonide EC was associated with a higher average eGFR during follow-up in the primary model (β = 4.090 mL/min/1.73 m²; p = 0.018), but this significance diminished in the matched cohort, suggesting the need for cautious interpretation.
Interpretation:
The effectiveness of telitacicept in reducing proteinuria may be more pronounced in patients with lower initial proteinuria levels, while budesonide EC showed a trend towards better eGFR outcomes that was not statistically significant after matching, highlighting the need for personalized treatment approaches.
Limitations:
Retrospective design may introduce bias, potentially affecting the reliability of the findings.
Potential confounding factors not fully accounted for could influence the results.
Conclusion:
The findings suggest that initial proteinuria levels may influence treatment efficacy, highlighting the need for further prospective studies to validate these results and improve clinical decision-making.