Targeted-release Budesonide (Nefecon) versus systemic glucocorticoids for IgA nephropathy: a placebo-anchored indirect treatment comparison of randomized controlled trials

Background

IgA nephropathy (IgAN) is a leading cause of end-stage renal disease, particularly in East Asia. Although systemic glucocorticoids are commonly used to delay progression, they are associated with significant adverse effects. Targeted-release budesonide (Nefecon) offers localized immunosuppression, targeting the gut-associated lymphoid tissue (Peyer's patches), with the aim of reducing systemic exposure. This study evaluates the efficacy and safety of Nefecon compared to systemic glucocorticoids through a placebo-anchored indirect treatment comparison.