泰它西普在IgA肾病中的疗效及安全性研究进展
Research Progress on the Clinical Efficacy and Safety of Telitacicept in the Treatment of IgA Nephropathy
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摘要: IgA肾病(immunoglobulin A nephropathy, IgAN)是全球最常见的原发性肾小球疾病, 占原发性肾小球肾炎的20%~40%, 约40%的患者在20年内进展至终末期肾病。传统治疗以肾素-血管紧张素系统抑制剂和糖皮质激素为主, 但部分患者疗效有限且面临感染风险。近年来, 靶向B细胞活化因子/B淋巴细胞刺激因子(B cell activating factor/B lymphocyte stimulator, BAFF/BLyS)和增殖诱导配体(a proliferation-inducing ligand, APRIL)的双靶点生物制剂泰它西普在IgAN治疗中展现出显著潜力, 其可同时中和BAFF/BLyS和APRIL, 抑制异常B细胞活化及致病性IgA1产生, 并显著降低尿蛋白水平、保护肾功能。本文系统综述其作用机制、临床疗效及安全性, 以期为IgAN的临床治疗提供借鉴。Abstract: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide, accounting for 20%-40% of primary glomerulonephritis cases. Approximately 40% of patients progress to end-stage renal disease within 20 years. Traditional treatments primarily involve renin-angiotensin system inhibitors and glucocorticoids, but some patients show limited response and face infection risks. In recent years, the dual-target biologic agent Telitacicept, which targets B cell-activating factor/B lymphocyte stimulator(BAFF/BLyS) and a proliferation-inducing ligand (APRIL), has demonstrated significant potentialin the treatment of IgAN. By simultaneously neutralizing BAFF/BLyS and APRIL, Telitacicept suppresses abnormal B-cell activation and the production of pathogenic IgA1, significantly reducing urinary protein levels and preserving renal function. This article systematically reviews its mechanism of action, clinical efficacy, and safety, aiming to provide insights for the clinical management of IgAN.
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