Improving Proteinuria With Sparsentan (SPAR) in Patients With IgA Nephropathy (IgAN): A Case Series
Topics: Nephrology IgAN Case series RWE
About the research
Summary
Background
- Sparsentan is a non-immunosuppressive, Dual Endothelin Angiotensin Receptor Antagonist (DEARA) indicated to slow kidney function decline in adults with primary IgA nephropathy who are at risk for disease progression1-4
- In PROTECT, sparsentan was well tolerated and reduced proteinuria in patients with IgA nephropathy and more often led to complete remission (CR) [<0.3 g/day] of proteinuria vs maximum labeled dose irbesartan1,5
- Real-world evidence (RWE) on the anti-proteinuric effect of sparsentan is limited1
Aim
The objective of this case series was to report the clinical features and treatment responses of 6 patients with IgA nephropathy receiving sparsentan in a real-world setting1
Approach
- Patients were elected by their treating healthcare professional (HCP)1
- Eligibility criteria included1:
- Biopsy-proven IgA nephropathy
- Sparsentan treatment for ≥3 months
- Patient consent
- Duration of follow-up on sparsentan ranged from 4 to 22 months1
- At the last follow-up, 5 patients were receiving ongoing sparsentan treatment, including 4 with concurrent sodium-glucose cotransporter-2 inhibitor (SGLT2i)1
- Prior to sparsentan initiation, 4 patients had received steroid treatment1
Key findings
- Addition or initiation of sparsentan treatment1
- Decreased proteinuria in 5 of 6 patients from initiation to last follow-up regardless of urine protein-creatinine ratio (UPCR) or estimated glomerular filtration rate (eGFR) prior to initiation, treatment history, and time since diagnosis
- Resulted in CR of proteinuria (UPCR < 0.3 g/g) in 2 patients, with 3 additional patients achieving UPCR of <0.5 g/g at any time during treatment
- Showed relatively stable eGFR and blood pressure
- Sparsentan treatment was generally well tolerated by these patients, with no discontinuations due to safety concerns1
Conclusions
- Overall, findings from this real-world setting support the safety and effectiveness of sparsentan in achieving or maintaining low proteinuria in patients with IgA nephropathy, meeting treatment goals of the draft 2024 KDIGO (Kidney Disease Improving Global Outcomes) guideline1
- Data also support the benefit of early initiation of sparsentan1
Related content
Footnotes
CR, complete remission; DEARA, Dual Endothelin Angiotensin Receptor Antagonist; eGFR, estimated glomerular filtration rate; IgA, immunoglobulin A; KDIGO, Kidney Disease Improving Global Outcomes; RWE, real-world evidence; SGLT2i, sodium-glucose cotransporter-2 inhibitor; UPCR, urine protein-creatinine ratio.
- Goshtaseb RR et al. Poster presented at: National Kidney Foundation Spring Clinical Meetings 2025; April 10-13, 2025; Boston, USA.
- Kohan DE et al. Clin Sci (Lond). 2024;138(11):645-662.
- FILSPARI® (sparsentan). Prescribing information. Travere Therapeutics, Inc.; September 2024.
- FILSPARI® (sparsentan). Summary of product characteristics. Vifor France; May 2024.
- Rovin BH et al. Lancet. 2023;402(10417):2077-2090.
MA-SP-25-0046 | April 2025