Targeted-release budesonide in recurrent IgA nephropathy after kidney transplantation

We read with interest the results of the randomized Efficacy and Safety of Nefecon in Patients With Primary IgA (Immunoglobulin A) Nephropathy (NefIgArd) trial showing that, in patients with IgA nephropathy (IgAN), targeted-release budesonide (TR-budesonide) reduced proteinuria, compared with placebo.1 IgAN often recurs after transplant, and strategies for management of IgAN recurrence are less clear than they are in the primary forms.2,3 In a single-center retrospective study, we examined the timecourse of proteinuria and estimated glomerular filtration rate in 10 consecutive adult kidney transplant recipients with biopsy-proven IgAN recurrence who were treated with TR-budesonide (Ferring Pharmaceuticals) between January 2015 to January 2022 at the Parma University Hospital, Parma, Italy (see the Supplementary File for details and statistical analyses).