Sparsentan in immunoglobulin A nephropathy: a profile of its use
Authorship and conflict of interest Young-A Heo, a salaried employee of Adis International Ltd/Springer Nature and an editor of Drugs & Therapy Perspectives, and Connie Kang, a salaried employee of Adis International Ltd./Springer Nature, were not involved in any publishing decisions for the manuscript and declare no relevant conflicts of interest. All authors contributed to this article and are responsible for its content.
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Abstract
Sparsentan (FILSPARI®), an oral, dual endothelin and angiotensin receptor antagonist, is an emerging new treatment option for patients with immunoglobulin A (IgA) nephropathy. Sparsentan received accelerated approval in the USA for the treatment of adults with IgA nephropathy who are at risk of rapid disease progression, generally a urine protein-to-creatinine ratio (UP/C) ≥ 1.5 g/g. In the ongoing phase 3 PROTECT trial in adults with IgA nephropathy, sparsentan was associated with favourable antiproteinuric effects, which were maintained over 110 weeks of treatment. The change in UP/C from baseline at week 36 was significantly greater with sparsentan than with irbesartan, an angiotensin receptor blocker. Early results from the 110-week final analysis of PROTECT also suggested that sparsentan may provide long-term benefits in preserving kidney function in patients with IgA nephropathy. Final analyses from the PROTECT trial, including its open-label extension period, are awaited with interest. Sparsentan was generally well tolerated, with its tolerability profile being similar to that of irbesartan. The most common treatment-emergent adverse events with sparsentan included peripheral oedema, hypotension, dizziness and hyperkalaemia. Longer-term data revealed no new safety signals.
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