APRIL-targeted and dual BAFF/APRIL blockade in primary IgA nephropathy: a systematic review and meta-analysis of randomized placebo-controlled trials.

Bo Qu, Lin Zhu, Qian Ren, Bo Wang, Bing Mao

Abstract readReview

In one paragraph

Review in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Bo QuDivision of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, School of Medicine and West China Hospital, Sichuan University, Chengdu, 610041, West China, China.

Lin ZhuDepartment of Gastroenterology, Sichuan Integrative Medicine Hospital, Chengdu, 610041, China.

Qian RenDepartment of Nephrology, School of Medicine and West China Hospital, Sichuan University, Chengdu, 610041, West China, China.

Bo WangDepartment of Nephrology, School of Medicine and West China Hospital, Sichuan University, Chengdu, 610041, West China, China.

Bing MaoDivision of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, School of Medicine and West China Hospital, Sichuan University, Chengdu, 610041, West China, China. maobing@scu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAPRIL-targeted and dual BAFF/APRIL blockade are upstream immune approaches for primary IgA nephropathy. We evaluated their efficacy and safety in adults with this disease.

methodsPubMed/MEDLINE, Embase, Web of Science, CENTRAL, ClinicalTrials.gov, WHO ICTRP and other registries were searched from inception to 8 May 2026. Randomized placebo-controlled trials of APRIL-targeted or dual BAFF/APRIL blockade in adults with biopsy-confirmed primary IgA nephropathy were included. The primary outcome was relative change in proteinuria, analyzed as the log ratio of means and back-transformed to the ratio of means (RoM). Serious adverse events were pooled as odds ratios. Risk of bias and certainty of evidence were assessed using RoB 2 and GRADE.

resultsNine full-text reports representing six independent trials were included. Five trials with 768 participants contributed to the primary proteinuria analysis. Active treatment reduced proteinuria versus placebo, with a pooled RoM of 0.539 (95%CI 0.477-0.609; p < 0.0001), corresponding to 46.1% lower proteinuria. Heterogeneity was low (I

conclusionAPRIL-targeted and dual BAFF/APRIL blockade reduced short-to-medium-term proteinuria in adults with primary IgA nephropathy. Longer follow-up is needed to clarify durability, immune safety and kidney outcome benefits.

Indexed as

APRILBAFFIgA nephropathyMeta-analysisProteinuria

Identifiers

PMID42350870

DOI10.1093/ndt/gfaf144

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.