[Expert Suggestions on Clinical Practice for Telitacicept in the Treatment of IgA Nephropathy (2026 Edition)].

Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide. The "four-hit hypothesis" is widely recognized as a key framework for understanding the pathogenesis of IgAN. B cell activating factor (BLyS/BAFF) and a proliferation-inducing ligand (APRIL) play crucial roles in promoting B cell activation and the production of galactose-deficient IgA1 and its corresponding autoantibodies. Telitacicept is a novel dual-target biologic agent that simultaneously inhibits both BLyS/BAFF and APRIL, potentially interrupting the critical immune mechanisms underlying IgAN and thereby slowing disease progression. Telitacicept has now been approved for the treatment of IgAN. Preliminary findings from clinical trials and real-world studies have shown that telitacicept can significantly reduce proteinuria, stabilize kidney function, and is generally well-tolerated with a favorable safety profile. However, the use of telitacicept in IgAN remains in the exploratory stage. Clinicians should carefully evaluate the latest evidence and balance benefits and risks to ensure rational use of telitacicept for this indication. This suggestion document aims to provide clinicians with scientific recommendations regarding the appropriate use of telitacicept in the treatment of IgAN, summarizing its mechanism of action, pharmacokinetic properties, clinical efficacy, and safety profile, with the goal of optimizing treatment strategies and improving patient outcomes.