Targeted-release budesonide modifies key pathogenic biomarkers in immunoglobulin A nephropathy: insights from the NEFIGAN trial

Kidney International, vol. 105, pp. 381–388

Abstract

efecon is the first approved treatment for patients with immunoglobulin A nephropathy (IgAN) at high risk of progression to kidney failure (accelerated approval: US Food and Drug Administration; conditional approval: European Medicines Agency).[1][2][3] Nefecon delivers budesonide, in a targeted formulation, to the gut-associated lymphoid tissue (GALT) of the ileum directly addressing immune dysregulation within this Peyer's patches-rich area of the GALT and downregulating the local production of the polymeric poorly O-galactosylated form of IgA1 or galactose-deficient IgA1 (Gd-IgA1) and generation of pathogenic IgA-containing immune complexes (IgA-IC).2 The aim of the current analysis is to explore the biochemical pathways through which Nefecon exerted its effects in patients treated in the NEFIGAN study.

Authors 14

1. David H. Wimbury

   University of Leicester

   Affiliation as printed

   Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK

   Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom

2. Jasraj S. Bhachu

   University of Leicester

   Affiliation as printed

   Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK

   Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom

3. Katrin Scionti

   University of Leicester

   Affiliation as printed

   Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK

   Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom

4. Jeremy R. Glissen Brown

   University of Leicester

   Affiliation as printed

   Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK

   Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom

5. Karen Molyneux

   University of Leicester

   Affiliation as printed

   Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK

   Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom

6. Claudia Seikrit Aachen Division of Nephrology and Clinical Immunology

   RWTH Aachen University

   Affiliation as printed

   Division of Nephrology and Clinical Immunology, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany

   Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany

7. Dita Maixnerová

   Charles University · General University Hospital in Prague

   Affiliation as printed

   Department of Nephrology, 1st Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic

   1st Faculty of Medicine, General University Hospital, Department of Nephrology, Charles University, 128 08 Prague, Czech Republic

8. Laura Pérez‐Alós

   Rigshospitalet

   Affiliation as printed

   Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Copenhagen, Denmark

9. Peter Garred

   Rigshospitalet

   Affiliation as printed

   Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Copenhagen, Denmark

10. Jürgen Floege Aachen Division of Nephrology and Clinical Immunology

    RWTH Aachen University

    Affiliation as printed

    Division of Nephrology and Clinical Immunology, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany

    Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany

11. Vladimı́r Tesař

    Charles University · General University Hospital in Prague

    Affiliation as printed

    Department of Nephrology, 1st Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic

    1st Faculty of Medicine, General University Hospital, Department of Nephrology, Charles University, 128 08 Prague, Czech Republic

12. Bengt Fellström

    Uppsala University · Uppsala University Hospital

    Affiliation as printed

    Department of Medical Sciences, Uppsala University, Uppsala University Hospital, Uppsala, Sweden

13. Rosanna Coppo

    Fondazione Ricerca Molinette · Ospedale Regina Margherita

    Affiliation as printed

    Fondazione Ricerca Molinette, Regina Margherita Hospital, Turin, Italy

14. Jonathan Barratt corresponding

    University of Leicester

    Affiliation as printed

    Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. Electronic address: jb81@leicester.ac.uk

    Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom