Efficacy and safety of BAFF/APRIL-pathway inhibitors versus placebo in adults with IgA nephropathy: a systematic review with pairwise and network meta-analysis.

What was studied

This review pooled trials of drugs that block the BAFF/APRIL path. The trials used placebo. They had 1,590 adults with biopsy-proven IgA nephropathy. The drugs were telitacicept, atacicept and sibeprenlimab. The review also ranked the drugs in a network analysis.

What they found

Versus placebo, these drugs lowered protein in the urine. They gave a small difference in kidney filtering, called eGFR. Blood IgA markers fell, but results varied a lot between trials. Serious side effects and dropouts were rarer with the drugs. Overall side effects did not differ. Injection-site reactions were more common. In the network, sibeprenlimab ranked highest for lowering urine protein. The drugs did not differ significantly from each other.

What it means for patients

The authors say the drugs lowered urine protein in a steady way. They say eGFR differed a little in the short term. They say no short-term safety signal was evident.

Why it is not certain yet

Longer follow-up is needed to find rare risks. It is unclear if the effect lasts. It was seen over about 6 to 12 months. Comparisons between drugs are exploratory. Longer trials with kidney failure as the goal are needed.

Source

Efficacy and safety of BAFF/APRIL-pathway inhibitors versus placebo in adults with IgA nephropathy: a systematic review with pairwise and network meta-analysis.

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