{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:11Z","timestamp":1789535051589,"version":"build-2803163510"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the efficacy and safety of telitacicept as add-on therapy versus standard of care (SOC) alone in immunosuppressant (IS)-na\u00efve patients with lupus nephritis (LN) and in patients with refractory LN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this bicentric, real-world, retrospective, triple-cohort study, we enrolled IS-na\u00efve LN patients receiving add-on telitacicept (Cohort 1), IS-na\u00efve LN patients receiving SOC alone (Cohort 2), and refractory LN patients receiving add-on telitacicept (Cohort 3). The primary endpoint was time to complete remission (CR). Secondary endpoints included renal remission rates at weeks 24 and 48, changes in serological and renal function parameters, glucocorticoid reduction, and safety. We assessed time to CR using the Kaplan-Meier (KM) method, Cox regression, and restricted mean event time (RMET) analysis if KM curves crossed early. Least squares mean (LSM) changes were estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We enrolled 55 eligible patients. Patients in Cohorts 1 (N\u00a0=\u00a016) and 3 (N\u00a0=\u00a017) received telitacicept 160 mg subcutaneously weekly in addition to SOC therapy; those in Cohort 2 (N\u00a0=\u00a022) received SOC alone. SOC regimens were predominantly mycophenolate mofetil-based. In IS-na\u00efve patients, Cohort 1 achieved CR numerically faster than Cohort 2 (HR\u00a0=\u00a01.268, 95% CI: 0.567\u20132.834, P\u00a0=\u00a00.578; RMET difference: \u22123.96 weeks, 95% CI: \u221217.13 to 9.21, P\u00a0=\u00a00.556). Among patients receiving telitacicept, Cohort 1 showed numerically higher CR (75.0% vs 64.7%) and TR rates (93.8% vs 76.5%) than Cohort 3, with numerically faster CR achievement (HR\u00a0=\u00a01.364, 95% CI: 0.600\u20133.102; RMET difference: \u22124.89 weeks; 95% CI: \u221218.50 to 8.73). Both telitacicept-treated cohorts showed substantial laboratory improvements, with Cohort 1 demonstrating the greatest eGFR improvement (+23.4 mL\/min\/1.73m\u00b2). A glucocorticoid-sparing effect was observed. Infections were the most common TEAEs; all were mild to moderate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Telitacicept demonstrated favorable efficacy and manageable safety in both IS-na\u00efve and refractory LN patients. In the treatment-na\u00efve setting, telitacicept achieved CR more quickly than SOC. Faster, higher responses in IS-na\u00efve versus refractory patients suggest a potential benefit of early intervention. These findings support early use of telitacicept and underscore the need for larger randomized controlled trials to confirm the benefits of early dual-target B-cell therapy in LN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1748931","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:29:47Z","timestamp":1789532987000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A real-world, triple-cohort study on the effectiveness and safety of telitacicept in immunosuppressant-na\u00efve and refractory lupus nephritis"],"prefix":"10.3389","volume":"17","author":[{"given":"Suren","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Nephrology, The First Affiliated Hospital of Quanzhou, Fujian Medical University","place":["Quanzhou, 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University","place":["Quanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The First Affiliated Hospital of Quanzhou, Fujian Medical University","place":["Quanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Second Affiliated Hospital of Fujian Medical University","place":["Quanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizhong","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The First Affiliated Hospital of Quanzhou, Fujian Medical University","place":["Quanzhou, 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