中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (04): 283-287.doi: 10.3969/j.issn.1671-4091.2025.04.005

• 临床研究 • 上一篇    下一篇

泰它西普治疗IgA肾病的有效性及安全性研究

朱丽君   陈 沛   吕继成   

  1. 00034 北京，1北京大学第一医院肾内科，北京大学肾脏病研究所，卫生部肾脏疾病重点实验室，慢性肾脏病防治教育部重点实验室，中国医学科学院免疫介导肾病诊治创新单元
    030000 山西，2山西省第二人民医院肾移植透析中心
  • 收稿日期:2024-11-11 修回日期:2025-01-29 出版日期:2025-04-12 发布日期:2025-04-12
  • 通讯作者: 陈沛 E-mail:glhrp@163.com

Clinical observation on the efficacy and safety of telitacicept in treatment of IgA nephropathy

ZHU Li-jun, CHEN Pei, LYU Ji-cheng   

  1. Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China; Innovation Unit of Diagnosis and Treatment of Immune-mediated Kidney Disease, Chinese Academy of Medical Sciences; Beijing 100034, China; 2Department of Kidney Transplantation and Dialysis Center, The Second People’s Hospital of Shanxi Province, Taiyuan 030000, China
  • Received:2024-11-11 Revised:2025-01-29 Online:2025-04-12 Published:2025-04-12
  • Contact: 100034 北京，1北京大学第一医院肾内科 E-mail:glhrp@163.com

摘要： 目的 探讨泰它西普治疗IgA肾病的有效性和安全性。 方法 回顾性收集自2022年3月─2024年3月在北京大学第一医院肾内科接受泰它西普治疗的IgA肾病患者临床资料，记录患者随访过程中的临床指标以及不良反应，评价药物的有效性和安全性。 结果 共纳入106例患者，中位随访时间5.4(3.2,11.5)月，泰它西普治疗6个月的尿蛋白(Z=-2.929，P=0.003)、IgA(t=8.857，P＜0.001)、IgG(t=5.305，P＜0.001)，IgM(t=6.732，P＜0.001)水平较基线下降。泰它西普治疗前尿蛋白＜3.5 g/d和估算肾小球滤过率(estimated glomerular filtration rate，eGFR)＞60 ml/(min·1.73m2)与泰它西普治疗后尿蛋白降至1.0 g/d以内相关(OR=6.483、4.552，95% CI:1.259～33.389、1.043～19.860，P=0.025、0.044)。观察到不良反应有感染和注射部位反应。 结论 泰它西普治疗可以降低IgA肾病患者尿蛋白水平，早期应用可能效果更为显著。

关键词: IgA肾病, 泰它西普, 有效性, 安全性

Abstract: Objective  To investigate the clinical efficacy and safety of telitacicept in the treatment of IgA nephropathy.  Methods  The clinical data of patients with IgA nephropathy treated with telitacicept from March 2022 to March 2024 were retrospectively collected. Their laboratory indicators and adverse reactions were recorded to evaluate the efficacy and safety of telitacicept.  Result  A total of 106 patients were analyzed, with a median medication time of 3.2 (2.2～5.7) months and median follow-up time of 5.4 (3.2～11.5) months. The 24-hour proteinuria decreased by 38.6% (-58.9%～1.8%) (Z=-2.929, P=0.003) from baseline at the sixth month after medication. The levels of IgA, IgG and IgM decreased from baseline; IgA decreased by 30.9% (t=8.857, P＜0.001), IgG 18.1% (t=5.305, P＜0.001) and IgM 43.6% (t=6.732, P＜0.001). Before medication, proteinuria ＜3.5 g/d (OR=6.483, 95% CI:1.259～33.389, P=0.025) and eGFR＞60ml/(min·1.73m2) (OR=4.552, 95% CI:1.043～19.860, P=0.044) were associated with proteinuria dropping to 1.0g/d after medication. Adverse reactions were infections and injection site reactions.  Conclusion  Telitacicept can significantly reduce proteinuria in patients with IgA nephropathy, and early application may be more effective.

Key words: IgA nephropathy, Telitacicept, Efficacy, Safety

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