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The purpose of this study is to evaluate the efficacy and safety of Telitacicept in patients with primary IgA nephropathy at risk of progressing to end-stage renal disease(ESRD), despite maximum tolerated treatment with renin-angiotensin system(RAS) blockade using angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II type I receptor blockers (ARBs).
This study consists of a 5-week screening period, a double-blind treatment period divided into phase A and phase B. Eligible subjects will be randomly assigned in a 1:1 ratio to receive either Telitacicept 240mg or placebo. Subjects will be given subcutaneous injection(SC) Telitacicept or placebo once a week for a total of 39 doses in phase A and once every 2 weeks for a total of 32 doses in phase B.
Primary endpoint of phase A will be measured at week 39. Primary endpoint of phase B will be measured at week 104.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Telitacicept | Experimental | Subjects will be given Telitacicept 240 mg SC once a week in phase A for a total of 39 doses and once every 2 weeks in phase B for a total of 32 doses. |
|
| Placebo | Placebo Comparator | Subjects will be given placebo SC once a week in phase A for a total of 39 doses and once every 2 weeks in phase B for a total of 32 doses. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Telitacicept | Biological | Subcutaneous injection |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in urine protein creatinine ratio (UPCR) | Based on a 24-hour urine collections. | 39 weeks |
| Annualized estimated glomerular filtration rate (eGFR) slope | eGFR is calculated using the CKD-EPI formula. | 104 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients with a 30% decrease in estimated glomerular filtration rate (eGFR) compared with baseline | eGFR is calculated using the CKD-EPI formula. | 39 weeks |
| Time to 30% reduction from baseline in eGFR |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in 24-hour urine protein | based on 24-hour urine collections | 39 weeks |
Inclusion Criteria:
Exclusion Criteria:
Subjects with abnormal laboratory tests, including but not limited to the following:
Patients with secondary IgA nephropathy, including but not limited to: Henoch-Schonlein purpura, ankylosing spondylitis, systemic lupus erythematosus, etc.;
Patients with other types of glomerular disease such as crescentic glomerulonephritis, minimal change nephropathy with IgA deposition;;
Renal transplant;
Patients with cirrhosis, as assessed by the investigator;
Patients who experienced any of the following cardiovascular and cerebrovascular events within 24 weeks prior to randomization: myocardial infarction, unstable angina, ventricular arrhythmia, NYHA Class II or higher heart failure, stroke, etc.;
Sitting position SBP>140 mmHg or DBP>90 mmHg for at least once at 2 visits during the screening period;
Patients with poorly controlled type 1 and type 2 diabetes (glycated hemoglobin A1c[HbA1c] > 8% or 64mmol/mol);
Treatment with immunosuppressants within 12 weeks prior to randomization, including but not limited to cyclophosphamide, azathioprine, mycophenolate, leflunomide, tacrolimus, cyclosporine, Tripterygium wilfordii;
Treatment with anti-CD20 therapy (for example, Rituximb Injection) within 24 weeks prior to randomization;
Received systemic glucocorticoid treatment within 12 weeks prior to randomization, excluding the followings: ① received systemic treatment with prednisolone ≤ 0.5mg/kg or equivalent glucocorticoid for non- IgA nephropathy for no more than 3 courses (≤ 2 weeks per course) in the past 52 weeks; ② topical administration or nasal inhalation;
Had hospitalization or intravenous anti-infective therapy for active infection within 4 weeks prior to randomization;
Patients with active tuberculosis;
Hepatitis B: patients with active or latent hepatitis B (potive HBcAb and HBV-DNA); According to the test results of hepatitis B five items, subjects with positive HBsAg will be excluded; subjects who are HBsAg-negative but HBcAb-positive, whether HBsAb is positive or negative, should be tested for HBV-DNA: if HBV-DNA is positive, patients should be excluded; if HBV-DNA is negative, patients can participate in the trial, and subjects are advised to take oral entecavir for prophylactic antiviral therapy during the trial;
Patients with hepatitis C;
Patients with HIV infection;
Patients with malignancy within the past 5 years, except for treated cutaneous basal cell carcinoma, cutaneous squamous cell carcinoma, colon polyps, or cervical cancer in situ;
Pregnant women, lactating women, and subjects with childbearing plans during the trial;
Allergic to biological products of human origin;
Participated in any clinical trial within 4 weeks or within 5 times the half-life of the investigational drug participating (whichever is longer) prior to randomization;
Received live vaccination within 4 weeks prior to randomization;
Drug or alcohol abuse/dependence within 52 weeks prior to randomization;
Other circumstances that, in the opinion of the investigator, are not suitable for participation in this study.
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| Name | Affiliation | Role |
|---|---|---|
| Jicheng Lv, M.D. | Peking University First Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Affiliated Hospital of Bengbu Medical University | Bengbu | Anhui | China | |||
| The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42127391 | Derived | Lv J, Liu L, Wang W, Wang X, Zuraw Q, Perkovic V, Fang J, Zhang H; TELIGAN Investigators. Telitacicept for IgA Nephropathy - Interim Analysis of a Phase 3 Trial. N Engl J Med. 2026 May 14;394(19):1916-1924. doi: 10.1056/NEJMoa2514415. | |
| 38299639 | Derived | Tunnicliffe DJ, Reid S, Craig JC, Samuels JA, Molony DA, Strippoli GF. Non-immunosuppressive treatment for IgA nephropathy. Cochrane Database Syst Rev. 2024 Feb 1;2(2):CD003962. doi: 10.1002/14651858.CD003962.pub3. |
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| Placebo | Drug | Placebo to Telitacicept |
|
eGFR is calculated using the CKD-EPI formula and confirmed by a second sample collection and calculation after at least 4 weeks.
| up to 104 weeks |
| Proportion of patients with a 40% decrease in estimated glomerular filtration rate (eGFR) compared with baseline | eGFR is calculated using the CKD-EPI formula and confirmed by a second sample collection and calculation after at least 4 weeks. | up to 104 weeks |
| Proportion of patients received rescue treatment. | patients using systemic immunosuppressive medications, glucocorticoids (GCSs), etc. | up to 104 weeks |
| Incidence and severity of adverse events | An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. | up to 104 weeks |
| Change from baseline in urine protein creatinine ratio (UPCR) | Based on 24-hour urine collections. | 52 weeks,78 weeks,104 weeks |
| Change from baseline in estimated glomerular filtration rate (eGFR) | eGFR is calculated using the CKD-EPI formula. | 39 weeks, 52 weeks,78 weeks,104 weeks |
| Change from baseline in UACR in urine albumin-to-creatinine ratio (UACR) | Based on 24-hour urine collections. | 39 weeks, 52 weeks,78 weeks,104 weeks |
| Time to composite endpoint event | The composite endpoint event is defined as initiation of maintenance renal dialysis (for at least 1 month), eGFR <15 mL/min/1.73 m^2, renal transplant, or death due to renal failure. eGFR is calculated using the CKD-EPI formula (CKD-EPI). | up to 104 weeks |
| Proportion of patients achieving urine protein creatinine ratio (UPCR) < 0.8 g/g | UPCR is calculated based on 24-hour urine collections; | 39 weeks, 52 weeks,78 weeks,104 weeks |
| Annualized estimated glomerular filtration rate (eGFR) slope | eGFR is calculated using the CKD-EPI formula. | 52 weeks |
| Hefei |
| Anhui |
| China |
| The Second Hospital of Anhui Medical University | Hefei | Anhui | China |
| The First Affiliated Hospital of Wannan Medical College | Wuhu | Anhui | China |
| Beijing Anzhen Hospital Affiliated to Capital Medical University | Beijing | Beijing Municipality | China |
| Beijing Hospital | Beijing | Beijing Municipality | China |
| Beijing Tsinghua Changgung Hospital | Beijing | Beijing Municipality | China |
| Peking University First Hospital | Beijing | Beijing Municipality | China |
| Peking University People's Hospital | Beijing | Beijing Municipality | China |
| Peking University Shougang Hospital | Beijing | Beijing Municipality | China |
| The First Affiliated Hospital of Army Medical University | Chongqing | Chongqing Municipality | China |
| The Second Affiliated Hospital of Chongqing Medical University | Chongqing | Chongqing Municipality | China |
| The First Affiliated Hospital of Xiamen University | Xiamen | Fujian | China |
| Zhongshan Hospital Xiamen University | Xiamen | Fujian | China |
| Gansu Provincial Hospital | Lanzhou | Gansu | China |
| Lanzhou University Second Hospital | Lanzhou | Gansu | China |
| The First Hospital of Lanzhou University | Lanzhou | Gansu | China |
| Guangdong Provincial People's Hospital | Guangzhou | Guangdong | China |
| The Second Affiliated Hospital of Guangzhou Medical University | Guangzhou | Guangdong | China |
| The Third Affiliated Hospital of Southern Medical University | Guangzhou | Guangdong | China |
| Zhujiang Hospital of Southern Medical University | Guangzhou | Guangdong | China |
| Shantou Central Hospital | Shantou | Guangdong | China |
| Longgang District People's Hospital of Shenzhen | Shenzhen | Guangdong | China |
| Peking University Shenzhen Hospital | Shenzhen | Guangdong | China |
| Shenzhen Hospital of Southern Medical University | Shenzhen | Guangdong | China |
| Shenzhen People's Hospital | Shenzhen | Guangdong | China |
| Affiliated Hospital of Guangdong Medical University | Zhanjiang | Guangdong | China |
| Zhuhai People's Hospital | Zhuhai | Guangdong | China |
| The First Affiliated Hospital of Guilin Medical University | Guilin | Guangxi | China |
| Liuzhou Workers' Hospital | Liuzhou | Guangxi | China |
| The First Affiliated Hospital of Guangxi Medical University | Nanning | Guangxi | China |
| Guizhou Provincial People's Hospital | Guiyang | Guizhou | China |
| Affiliated Hospital of Zunyi Medical University | Zunyi | Guizhou | China |
| Affiliated Hospital of Hebei University | Baoding | Hebei | China |
| Cangzhou Central Hospital | Cangzhou | Hebei | China |
| Handan First Hospital | Handan | Hebei | China |
| First Hospital of Qinhuangdao | Qinhuangdao | Hebei | China |
| The Second Hospital of Hebei Medical University | Shijiazhuang | Hebei | China |
| Xingtai People's Hospital | Xingtai | Hebei | China |
| The First Affiliated Hospital of Hebei North University | Zhangjiakou | Hebei | China |
| The First Affiliated Hospital of Henan University of science and Technology | Luoyang | Henan | China |
| Nanyang Central Hospital | Nanyang | Henan | China |
| Henan Provincial People's Hospital | Zhengzhou | Henan | China |
| The First Affiliated Hospital of Zhengzhou University | Zhengzhou | Henan | China |
| Renmin Hospital of Wuhan University | Wuhan | Hubei | China |
| Zhongnan Hospital of Wuhan University | Wuhan | Hubei | China |
| The Second Xiangya Hospital of Central South University | Changsha | Hunan | China |
| The Third Xiangya Hospital of Central South University | Changsha | Hunan | China |
| Xiangya Hospital of Central South University | Changsha | Hunan | China |
| The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology | Baotou | Inner Mongolia | China |
| The Affiliated Hospital of Inner Mongolia Medical University | Hohhot | Inner Mongolia | China |
| Changzhou No.2 People's Hospital | Changzhou | Jiangsu | China |
| Jiangsu Provincial People's Hospital | Nanjing | Jiangsu | China |
| Zhongda Hospital Southeast University | Nanjing | Jiangsu | China |
| Wuxi People's Hospital | Wuxi | Jiangsu | China |
| The Affiliated Hospital of Xuzhou Medical University | Xuzhou | Jiangsu | China |
| Jiangxi Provincial People's Hospital | Nanchang | Jiangxi | China |
| The First Affiliated Hospital of Nanchang University | Nanchang | Jiangxi | China |
| The Second Affiliated Hospital of Nanchang University | Nanchang | Jiangxi | China |
| China-Japan Union Hospital of Jilin University | Changchun | Jilin | China |
| Jilin Province People's Hospital | Changchun | Jilin | China |
| The First Hospital of Jilin University | Changchun | Jilin | China |
| The Second Hospital of Jilin University | Changchun | Jilin | China |
| General Hospital of Northern Theatre Command | Shenyang | Liaoning | China |
| Shengjing Hospital of China Medical University | Shenyang | Liaoning | China |
| The Affiliated Central Hospital of Shenyang Medical College | Shenyang | Liaoning | China |
| General Hospital of Ningxia Medical University | Yinchuan | Ningxia | China |
| The First Affiliated Hospital of Xi'an Jiaotong University | Xi'an | Shaanxi | China |
| The Second Affiliated Hospital of Xi'an Jiaotong University | Xi'an | Shaanxi | China |
| Qilu Hospital of Shandong University | Jinan | Shandong | China |
| Shandong Provincial Hospital | Jinan | Shandong | China |
| Shandong Provincial Qianfoshan Hospital | Jinan | Shandong | China |
| Linyi People's Hospital | Linyi | Shandong | China |
| The Affiliated Hospital of Qingdao University | Qingdao | Shandong | China |
| Yantai Yuhuangding Hospital | Yantai | Shandong | China |
| Huashan Hospital,Fudan University | Shanghai | Shanghai Municipality | China |
| Renji Hospital,Shanghai Jiaotong University School of Medicine | Shanghai | Shanghai Municipality | China |
| Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine | Shanghai | Shanghai Municipality | China |
| First Hospital of Shanxi Medical University | Taiyuan | Shanxi | China |
| Second Hospital of Shanxi Medical University | Taiyuan | Shanxi | China |
| Shanxi Bethune Hospital | Taiyuan | Shanxi | China |
| Shanxi Provincial People's Hospital | Taiyuan | Shanxi | China |
| Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital | Chengdu | Sichuan | China |
| West China Hospital of Sichuan University | Chengdu | Sichuan | China |
| The Second People's Hospital of Yibin | Yibin | Sichuan | China |
| The Second Hospital of Tianjin Medical University | Tianjin | Tianjin Municipality | China |
| Tianjin Medical University General Hospital | Tianjin | Tianjin Municipality | China |
| People's Hospital of Xinjiang Uygur Autonomous Region | Ürümqi | Xinjiang Uygur Autonomous Region | China |
| The First Affiliated Hospital of Xinjiang Medical University | Ürümqi | Xinjiang Uygur Autonomous Region | China |
| The First People's Hospital of Yunnan Province | Kunming | Yunnan | China |
| The First Affiliated Hospital, Zhejiang University School of Medicine | Hangzhou | Zhejiang | China |
| Zhejiang Provincial People's Hospital | Hangzhou | Zhejiang | China |
| Jinhua Municipal Central Hospital | Jinhua | Zhejiang | China |
| Ningbo Municipal Hospital of Traditional Chinese Medicine | Ningbo | Zhejiang | China |
| Ningbo No.2 Hospital | Ningbo | Zhejiang | China |
| The First Affiliated Hospital of Ningbo University | Ningbo | Zhejiang | China |
| Taizhou Hospital of Zhejiang Province | Taizhou | Zhejiang | China |
| First Affiliated Hospital of Wenzhou Medical University | Wenzhou | Zhejiang | China |
| Wenzhou Central Hospital | Wenzhou | Zhejiang | China |
| Wenzhou People's Hospital | Wenzhou | Zhejiang | China |
| Tongde Hospital of Zhejing Province | Hangzhou | Zhejing | China |
| ID | Term |
|---|---|
| D005922 | Glomerulonephritis, IGA |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| ID | Term |
|---|---|
| D005921 | Glomerulonephritis |
| D009393 | Nephritis |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
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| ID | Term |
|---|---|
| C000722462 | telitacicept |
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