Objective:

To explore different combinations of Oxford Classification activity scores in guiding immunotherapy for IgA nephropathy and analyze the association of composite pathological scores, including the newly defined SumMEC, with immunotherapy for proteinuria remission.

Approach:

Key Findings:

• Immunotherapy was associated with a 22% increase in proteinuria remission at 12 months (HR 1.22; 95% CI 1.07-1.40; p=0.004).
• The benefit of immunotherapy was observed primarily in patients with high SumMEC scores.
• The effects of immunotherapy on 6-month proteinuria remission were comparable to those at 12 months.

Interpretation:

The use of immunosuppressive agents may improve proteinuria remission in patients with IgA nephropathy, particularly in those with high SumMEC scores.

Conclusion:

Composite pathological scores may aid in guiding immunotherapy decisions in IgA nephropathy.

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