ArticleInternational urology and nephrology2026
Efficacy and safety of telitacicept for rituximab-refractory membranous nephropathy.
Article 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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Abstract
backgroundRituximab (RTX) is the first-line treatment for primary membranous nephropathy (MN), but 30-40% of patients are refractory. Persistent activation of the BAFF/APRIL pathway underlies RTX resistance. Telitacicept, a dual BAFF/APRIL inhibitor, may offer a novel therapeutic approach.
methodsThis retrospective study included 11 patients with RTX-refractory primary MN who received weekly subcutaneous telitacicept (160 mg) and were followed for ≥6 months. Primary endpoint was proteinuria remission rate at 6 months. Secondary endpoints included anti-PLA2R antibody levels, renal function, and safety.
resultsMean age was 49.5 years; 63.6% were male. After 6 months, objective response rate was 63.6% (27.3% complete remission, 36.4% partial remission). In the whole cohort, 24-h urine protein decreased from 7.89 ± 2.84 to 2.91 ± 2.66 g/day (P = 0.004); serum albumin increased from 25.32 ± 4.01 to 31.92 ± 8.35 g/L (P = 0.010). In the 7 patients who achieved remission, 24hUP decreased from 8.45 ± 3.50 to 1.28 ± 1.20 g/day (P = 0.003) and serum albumin increased from 26.24 ± 4.21 to 36.69 ± 6.45 g/L (P = 0.002). Anti-PLA2R antibodies declined from 47.44 (32.36-98.32) to 7.25 (1.65-26.30) RU/mL (P = 0.001), with 45.5% achieving immune remission; antibody rebound between 3 and 6 months was observed in 5 patients, 4 of whom had a dose reduction. Renal function remained stable (eGFR 65.2 ± 20.6 to 61.5 ± 16.9 mL/min/1.73 m
conclusionTelitacicept demonstrates favorable efficacy and acceptable safety in RTX-refractory MN, representing a promising treatment option for this challenging population.
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