{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T08:05:34Z","timestamp":1773821134718,"version":"3.50.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"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>Background<\/jats:title>\n                    <jats:p>The mechanisms of action of mycophenolate mofetil (MMF) and hydroxychloroquine (HCQ) differ in the treatment of IgA nephropathy (IgAN), and the two may have a synergistic effect in delaying disease progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This multicenter retrospective cohort study included patients aged 18\u201360 years with biopsy-confirmed primary IgAN, with 83 patients receiving MMF plus HCQ (combined group) and 94 receiving MMF alone (MMF group). All patients had an estimated glomerular filtration rate &amp;gt; 45 ml\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      and urine protein (UP) &amp;gt;0.75 g\/d after receiving renin-angiotensin-aldosterone system inhibitors for more than 4 weeks. Propensity score matching was performed with a matching ratio of 1:1. The primary outcomes were complete response (CR) and overall remission (OR) rates at 12 months, which were analyzed using the chi-square test. CR was defined as a 24-hour UP \u22640.3 g\/d and stable renal function. The OR comprised CR and partial remission. Partial remission was defined as a &amp;gt;50.0% reduction from baseline in UP, with a final level of &amp;lt;1 g\/d.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, the CR rates at 12 months were 63.8% (37\/58) and 37.9% (22\/58) in the combination and MMF groups, respectively (odds ratio: 0.59, 95% CI 0.40\u20130.87,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.005). OR was achieved by 53 (91.4%) and 43 (74.1%) participants in the combined and MMF groups, respectively (odds ratio: 0.45, 95% CI 0.21\u20130.99,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.014). Kaplan\u2013Meier analysis also showed that the probability of achieving CR and OR was significantly higher in the combination group (log-rank\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.008 and 0.001, respectively). Subgroup analyses showed that patients with UP &amp;gt;2 g\/d and eGFR &amp;lt;60 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      were more likely to achieve OR. The incidence of adverse events was comparable between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combination therapy with MMF and HCQ was associated with higher remission rates and greater reduction in UP at 12 months, particularly among those with baseline UP &amp;gt;2 g\/d or eGFR between 45 and 60 mL\/min\/1.73 m\u00b2, supporting its potential short-term renal benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1783946","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:05:56Z","timestamp":1773817556000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A multicenter retrospective cohort study on the efficacy and safety of mycophenolate mofetil plus hydroxychloroquine therapy in IgA nephropathy"],"prefix":"10.3389","volume":"17","author":[{"given":"Yang","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Nephrology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Affiliated Ganzhou Hospital, Jiangxi Medical College, Nanchang University","place":["Ganzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjun","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The First Affiliated Hospital of Gannan Medical University","place":["Ganzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaiping","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Affiliated Ganzhou Hospital, Jiangxi Medical College, Nanchang University","place":["Ganzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baoqin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Xinyu People\u2019s Hospital","place":["Xinyu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Shangrao People\u2019s Hospital","place":["Shangrao, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shizhang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Yichun People\u2019s Hospital","place":["Yichun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shufang","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daijin","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Health Management Center, Jiangxi Provincial People\u2019s Hospital, The First Affiliated Hospital of Nanchang Medical College","place":["Nanchang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaosi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, 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