IgA nephropathy (IgAN) is a chronic progressive kidney disease, and long-term control of proteinuria and prevention of relapse are crucial for delaying disease progression. Patients with IgAN who achieve proteinuria remission after receiving Nefecon for 9 months or longer still face the risk of proteinuria relapse after treatment discontinuation. This study is to evaluate the efficacy and safety of Nefecon 8 mg treatment for 15 months as a maintenance therapy for prevention of proteinuria relapse in proteinuria-remitted patients.
Diagnosed primary IgAN with biopsy verification.
Female or male participants ≥18 years of age.
Completion of 9 months of Nefecon 16 mg QD at the Baseline visit.
Proteinuria ≥ 1g/d prior to initiation of Nefecon
Systemic diseases that may cause mesangial immunoglobulin A deposition, including but not limited to IgAVN, systemic lupus erythematosus, dermatitis herpetiformis, ankylosing spondylitis, and others;
Presence of other glomerulopathies (e.g., C3 glomerulopathy, nephrotic syndrome and/or diabetes nephropathy), active infection, severe hepatic impairment (Child-Pugh Class C), congestive heart failure, and a history of malignant tumor within the past 5 years.
On current or planned dialysis or kidney transplantation;
Participants who have been treated with systemic glucocorticoids and immunosuppressive agents within the past 3 months, including mycophenolate mofetil, hydroxychloroquine, cyclophosphamide, azathioprine, leflunomide, calcineurin inhibitors, and Chinese traditional medicines with immunosuppressive effects (such as Tripterygium wilfordii, Sinomenium acutum, Tripterygium Glycosides Tablets, Kunxian Capsules, Kunming Shanhaitang Tablets, etc.); treatment with B-cell targeted biological agents (such as telitacicept, etc.); complement pathway inhibitors, etc.;
Parallel
NEFECON
DrugNEFECON 8mg once daily by mouth for 15 months
Placebo
DrugPlacebo oral capsule once daily by mouth for 15 months
Time to first occurrence of proteinuria relapse
≥100% increase in UPCR and UPCR ≥0.5 g/g, separated by at least 1 week
eGFR slope
eGFR slope from baseline to Month 15
The proportion of patients with UPCR ≥0.5 g/g
The proportion of patients with UPCR ≥0.5 g/g within 15 months
The proportion of patients with UPCR ≥1 g/g
The proportion of patients with UPCR ≥1 g/g within 15 months
Changes in UPCR and 24-hour urinary protein
Changes in UPCR and 24-hour urinary protein from baseline to Months 3, 6, 9, 12, and 15
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