{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:10:16Z","timestamp":1791274216464,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":111,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>IgA nephropathy (IgAN) is the most common primary glomerular disease worldwide. B-cell activating factor (BAFF) and A proliferation-inducing ligand (APRIL) are cytokines involved in B-cell activation and survival, contributing to the pathogenesis of IgAN. This meta-analysis aimed to evaluate the efficacy, safety, and biomarkers of BAFF- or APRIL-targeted therapies in patients with IgAN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Scopus, and the Cochrane Library for randomized controlled trials (RCTs) comparing BAFF- or APRIL-targeted drugs with placebo in adults with IgAN, published up to December 2024 and written in English. Efficacy outcomes were the mean percent change in the 24-hour urine protein-to-creatinine ratio (UPCR) and the mean change in the estimated glomerular filtration rate (eGFR) from baseline. Safety included the incidence of adverse events. The biomarkers we used were changes in serum Gd-IgA1, IgG, IgA, and IgM from baseline. The risk of bias and the certainty of evidence were assessed using RoB v2.0 and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). We used the R software version 4.2.1 for statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four Phase II RCTs, including 331 patients, were included, with three studies having a low risk of bias, while there were some concerns regarding one study. Compared to placebo, BAFF- or APRIL-targeted drugs significantly reduced 24-hour UPCR (mean difference [MD] \u221238.94%; 95% confidence interval [CI] \u221258.98 to \u221218.90; P = 0.0001; I\u00b2 = 0%) and significantly improved the eGFR (MD 7.05\u2005mL\/min\/1.73\u2005m\u00b2; 95% CI 3.83 to 10.27; P &amp;lt; 0.0001; I\u00b2 = 0%). Adverse events did not significantly differ between the study groups. BAFF- or APRIL-targeted drugs significantly decreased serum Gd-IgA1, IgG, IgA, and IgM compared with placebo, indicating lower immune complex formation and response to treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BAFF- or APRIL-targeted therapies appear to be effective and safe in reducing proteinuria in patients with IgAN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration ID<\/jats:title>\n                    <jats:p>CRD42024598157<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajaf002","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:24:41Z","timestamp":1776824681000},"page":"50-62","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy, safety, and biomarker changes of B-cell\u00a0activating factor and A proliferation-inducing ligand-targeted therapies in IgA nephropathy: a\u00a0systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1530-6523","authenticated-orcid":false,"given":"Rafael","family":"Dos Santos Borges","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Federal University of Minas Gerais (UFMG) , 190 Prof. Alfredo Balena Avenue\u2014Santa Efig\u00eania, Belo Horizonte, MG 30130100 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5594-0664","authenticated-orcid":false,"given":"Rodrigo","family":"Lara Santos","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Federal University of Minas Gerais (UFMG) , 190 Prof. Alfredo Balena Avenue\u2014Santa Efig\u00eania, Belo Horizonte, MG 30130100 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Sousa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Federal University of Uberl\u00e2ndia (UFU) , 1720 Par\u00e1 Avenue\u2014Umuarama, Uberl\u00e2ndia, MG 38400902 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6152-2564","authenticated-orcid":false,"given":"Giovanni","family":"Gosch Berton","sequence":"additional","affiliation":[{"name":"Department of Medicine and Department of Molecular Medicine, Universit\u00e0 degli Studi di Padova , 2 Via VIII Febbraio, Padova 35122 ,","place":["Italy"]},{"name":"School of Medicine, University of Passo Fundo (UPF) , BR 285 Km 292,7\u2014S\u00e3o Jos\u00e9, Passo Fundo, RS 99052900 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9222-3882","authenticated-orcid":false,"given":"Ana Cristina","family":"Sim\u00f5es e Silva","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Federal University of Minas Gerais (UFMG) , 190 Prof. Alfredo Balena Avenue\u2014Santa Efig\u00eania, Belo Horizonte, MG 30130100 ,","place":["Brazil"]},{"name":"Interdisciplinary Laboratory of Medical Investigation, Unit of Pediatric Nephrology, Faculty of Medicine , UFMG. 190 Prof. Alfredo Balena Avenue\u2014Santa Efig\u00eania, Belo Horizonte, MG 30130100 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"2026060416363202700_aajaf002-B1","doi-asserted-by":"publisher","first-page":"1795","DOI":"10.1681\/ASN.2011050464","article-title":"The pathophysiology of IgA nephropathy","volume":"22","author":"Suzuki","year":"2011","journal-title":"J Am Soc Nephrol"},{"key":"2026060416363202700_aajaf002-B2","doi-asserted-by":"publisher","first-page":"S13","DOI":"10.1016\/j.nephro.2018.02.010","article-title":"Treatment of IgA nephropathy: recent advances and prospects","volume":"Suppl 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