Telitacicept use in children with IgA vasculitis nephritis: preliminary observations

To investigate the safety and efficacy of telitacicept in children with immunoglobulin (Ig) A vasculitis nephritis (IgAVN).

This is a case series of children with biopsy-confirmed IgAVN who received glucocorticoid with or without a second immunosuppressant and presented with urinary protein levels > 0.3 g/day/kg. The patients were administered telitacicept subcutaneously weekly as an adjunct to the standard treatment. The laboratory indices were assessed before and 24 weeks post-treatment, and the treatment’s efficacy and side effects were analyzed.

Seven patients (six males and one female) were enrolled in the study. The median age and body weight of patients were 13 years and 48 kg, respectively. The median disease duration was 29 months. After treatment with telitacicept (80 or 160 mg administered per week) until the 24th week, the 24-h urinary protein levels, percentage of CD19 + B cells, and IgA and IgM levels were decreased compared to the baseline values (P < 0.05). Serum albumin and complement C4 levels increased significantly in response to the treatment (P < 0.05). The serum creatinine, blood urea, serum total protein, IgG, and complement C3 levels and urine erythrocyte counts were not significantly different (P > 0.05) from the respective pre-treatment values. The enrolled patients did not experience any drug reactions.

The combination of telitacicept and the standard treatment showed good clinical effects in children with IgAVN. This treatment showed good safety and had good tolerance.