Efficacy and safety of henagliflozin in IgA nephropathy: A real-world observational study from China.

BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are now recommended as first-line therapies for chronic kidney disease. However, real-world evidence on henagliflozin, China's first-developed SGLT2 inhibitor, for treating IgA nephropathy (IgAN) is lacking. This study explored the real-world efficacy and safety of henagliflozin in Chinese IgAN patients. MATERIALS AND METHODS: This study retrospectively reviewed 48 IgAN patients on henagliflozin for 12 weeks. The primary outcome was the urinary albumin-to-creatinine ratio (UACR). Secondary outcomes included estimated glomerular filtration rate (eGFR), serum creatinine (Scr), uric acid (UA), and albumin (Alb). Adverse events (AEs) were also recorded. RESULTS: Henagliflozin induced a significant reduction in UACR between baseline and week 12 (227.26; IQR, 90.13 - 677.85 vs. 153.06; IQR, 24.68 - 401.76 mg/g; p < 0.001), with a median decrease of 47.9%. Clinical response, defined as a ≥ 30% decrease in UACR, was achieved in 64.6% of patients by week 12. The UA levels also decreased markedly (p < 0.001). The eGFR declined until week 8 (p ≤ 0.015) but returned to near-baseline level by week 12 (p = 0.055). Scr increased over time (p = 0.005), and Alb improved until week 8 (p ≤ 0.007) and then plateaued at week 12 (p = 0.45). AEs included urinary tract infections in 5 patients, Scr increase of ≥ 50% in 1, and hyperkalemia in 1. CONCLUSION: Henagliflozin demonstrated significant albuminuria- and UA-lowering effects over 12 weeks in Chinese IgAN patients. With renal-metabolic benefits and favorable safety, henagliflozin is emerging as an encouraging therapeutic option for IgAN.