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泰它西普治疗IgA肾病的有效性及安全性分析

Efficacy and safety analysis of telitacicept in treatment of IgA nephropathy

    摘要
  • 摘要:
    目的 评估泰它西普在IgA肾病(IgAN)治疗中的有效性及安全性。
    方法 回顾性分析9例使用泰它西普治疗的IgAN患者临床资料。比较治疗前后尿蛋白与肌酐比值(UPCR)、血清肌酐、估算肾小球滤过率(eGFR)等指标变化。记录并分析随访过程中不良事件发生情况。
    结果 9例患者(男7例, 77.78%; 女2例, 22.22%)均完成12周治疗。纳入患者最常见的临床表现为持续性蛋白尿，基线UPCR为0.91(0.59, 1.83)g/g, 血清肌酐为(120.11±39.58)μmol/L, eGFR为(67.33±25.11) mL/(min·1.73 m2)。治疗12周后, UPCR低于基线，差异有统计学意义(P < 0.01); 治疗前后, IgAN患者血清肌酐、血清尿酸、eGFR、血清白蛋白比较，差异无统计学意义(P>0.05)。治疗第4、8、12周时UPCR均数小于基线，差异有统计学意义(F=10.032, P=0.008); eGFR均数与基线比较，差异无统计学意义(F=2.046, P=0.134)。治疗12周, 9例IgAN患者总体缓解率为66.67%; 所有患者对泰它西普耐受性较好，共发生不良事件(皮肤感染)1例。
    结论 9例IgAN患者使用泰它西普治疗后，其尿蛋白显著下降，肾功能维持稳定，且安全性较好。

     

    Abstract:
    Objective To evaluate the efficacy and safety of telitacicept in treatment of IgA nephropathy (IgAN).
    Methods The clinical data of 9 patients with IgAN treated with telitacicept were retrospectively analyzed. Change of urine protein to creatinine ratio (UPCR), serum creatinine, estimated glomerular filtration rate (eGFR) and other indicators were compared before and after treatment. Adverse events during follow-up were recorded and analyzed.
    Results Nine patients 7 males (77.78%), 2 females (22.22%) completed 12 weeks of treatment. The most common clinical manifestations of included patients were persistent albuminuria, baseline UPCR of 0.91 (0.59, 1.83) g/g, serum creatinine of (120.11±39.58) μmol/L and eGFR of (67.33±25.11) mL/(min·1.73 m2). After 12 weeks of treatment, UPCR was significantly lower than baseline (P < 0.01); before and after treatment, there was no significant difference in serum creatinine, serum uric acid, eGFR and serum albumin in IgAN patients (P>0.05). At 4, 8 and 12 weeks, the mean UPCR was significantly lower than baseline (F=10.032, P=0.008); there was no significant difference in eGFR mean and baseline (F=2.046, P=0.134). After 12 weeks of treatment, the overall remission rate of 9 IgAN patients was 66.67%. All patients were well tolerated by telitacicept, and one patient with adverse event occurred (skin infection).
    Conclusion In 9 IgAN patients treated with telitacicept, urinary protein is decreased significantly and renal function is remained stable with good safety.

     

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