Recent Advancements in the Therapeutic Landscape of IgA Nephropathy and the Impact of Dual Blockers: Telitacicept.

UNLABELLED: Immunoglobulin A nephropathy (IgAN) ranges in heterogeneity and unpredictable course, leading to high morbidity and mortality. For decades, the mainstream treatment protocol for IgAN has been long-term corticosteroids, which is combined with immunosuppression therapy in a subset of patients. Recent studies have demonstrated that side effects related to long-term corticosteroid and immunosuppressive therapy limit patient adherence to long-term treatment and subsequently impair efficacy. Therefore, there is an urgent need for a novel long-term regimen that spares corticosteroid- and immunotherapy-related side effects and prevent the patient from progressing to end-stage renal disease. Because of the lack of consensus on the treatment protocol, research has been conducted to explore pathogenesis-specific treatments for IgAN. In recent years, the BAFF/APRIL axis has been shown to play a principal role in the pathogenesis of IgAN. In this review, we explore the recent clinical trials that specifically target the pathogeneses of IgAN and review the deeper aspects of the current IgAN treatment protocol. Additionally, we review diverse perspectives on drugs that interfere with the BAFF/APRIL axis, particularly telitacicept-a fully human IgG1-Fc soluble fusion protein.

SIGNIFICANCE STATEMENT: Better understanding of IgA nephropathy has helped researchers to discover new targeted drugs that act on specific pathogenic pathways. These treatments offer a new way to slow or stop kidney damage due to this condition. This review explains the key role of the BAFF/APRIL pathway and critiques the therapeutic role of telitacicept. It also provides a clear, easy-to-follow summary of real-world targeted therapy for doctors, researchers, and the public.