TRF-Budesonide Reduces Proteinuria in IgA Nephropathy

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A targeted-release formulation of budesonide—designed to deliver drug to the distal ileum—reduces proteinuria in patients with IgA nephropathy who don’t respond to first-line treatment, reports a trial in The Lancet.

The phase 2b NEFIGAN trial included patients with confirmed IgA nephropathy and persistent proteinuria at 62 European nephrology clinics. All patients were on optimized renin-angiotensin system (RAS) blockade, which continued throughout the study. After stratification by baseline urine protein creatinine ratio (UPCR), patients were randomly assigned to TRF-budesonide, 8 or 16 mg/d, or placebo. The main efficacy outcome was change in UPCR from baseline to 9 months of