Sparsentan in Combination With Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in Patients With IgA Nephropathy (IgAN): A Case Series
American Society of Nephrology (ASN) Kidney Week – 2024
Sparsentan (SPAR) Added to Stable Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2is) in Adults With IgA Nephropathy (IgAN) in the Phase 2 SPARTACUS Trial
Poster
Published on June 4, 2025
Contributors
Ayoub I, Tang S, Kooienga L et al.
Ayoub I, Tang S, Kooienga L et al.
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 IgA nephropathy who are at risk for disease progression1-4
- Treatment with sparsentan led to sustained proteinuria reduction and preservation of kidney function in the Phase 3 PROTECT study3
- In independent subgroup analyses from DAPA-CKD and EMPA-KIDNEY, sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduced albuminuria and kidney disease progression in patients with IgA nephropathy5,6
- An interim analysis of the Phase 2 SPARTACUS trial showed that in adults with IgA nephropathy receiving stable SGLT2i therapy, replacing renin-angiotensin system inhibitors (RASi) with sparsentan led to further reductions in albuminuria7
Aim
To report final data from SPARTACUS, which evaluated the efficacy and safety of replacing RASi with sparsentan in adults with IgA nephropathy receiving stable SGLT2i therapy1
Figure. Study design1
About the figure
SPARTACUS was a 24-week Phase 2, exploratory, open-label, single-arm, multicenter study of sparsentan when added to a stable SGLT2i in patients with IgA nephropathy at risk for disease progression.1
Resources
Key findings
Replacing RASi with sparsentan in patients receiving stable SGLT2i treatment resulted in rapid and sustained reductions in proteinuria, with urine protein-creatinine ratio (UPCR) percentage decreasing by approximately 45% from baseline over 24 weeks1
Figure. Change in UPCR at each visit over 24 weeks1
Treatment with sparsentan and SGLT2i also led to rapid and sustained reductions in urine albumin-creatinine ratio (UACR), with a mean decrease of approximately –56% from baseline to Week 24, and nearly one-third of patients achieved UACR <0.2 g/g1
Figure. Percent of patients achieving UACR reduction endpoints at Week 241
eGFR remained relatively stable during the study following the replacement of RASi with sparsentan in patients receiving stable SGLT2i treatment1
Figure. Change in eGFR values at each visit over 24 weeks1
Adding sparsentan to a stable SGLT2i was generally well tolerated, with no unexpected safety signals1
The most common TEAEs included hypotension (n=7), headache (n=4), edema (n=4), peripheral edema (n=4), upper respiratory tract infection (n=3), and dizziness (n=3)1
Table. Patients with any TEAE
Read more about concomitant use of sparsentan and an SGLT2i in the PROTECT open-label extension (OLE) study and in a case series describing real-world experience8,9
Conclusions
In patients with IgA nephropathy receiving stable SGLT2i therapy, switching from a maximally tolerated RASi to sparsentan resulted in rapid and sustained reductions in albuminuria and proteinuria, and achievement of UACR reduction endpoints1
Combination therapy with SGLT2i therapy and sparsentan was also well tolerated, with no unexpected safety signals1
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Footnotes
DEARA, Dual Endothelin Angiotensin Receptor Antagonist; eGFR, estimated glomerular filtration rate; IgA, immunoglobulin A; OLE, open-label extension; RASi, renin-angiotensin system inhibitor; SGLT2i, sodium-glucose cotransporter-2 inhibitor; UACR, urine albumin-creatinine ratio; UPCR, urine protein-creatinine ratio.
- Ayoub I et al. Presented at: European Renal Association 2025; June 4-7, 2025; Vienna, Austria.
- Kohan DE et al. Clin Sci (Lond). 2024;138(11):645-662.
- Rovin BH et al. Lancet. 2023;402(10417):2077-2090.
- FILSPARI® (sparsentan) Prescribing Information. San Diego, CA: Travere Therapeutics, Inc. 9/2024.
- Wheeler DC et al. Kidney Int. 2021;100(1):215-224.
- EMPA-KIDNEY Collaborative Group. Lancet Diabetes Endocrinol. 2024;12(1):51-60.
- Ayoub I et al. Poster presented at: American Society of Nephrology Kidney Week 2024; October 23-27, 2024; San Diego, CA. FR-PO849.
- Kooienga I et al. Poster presented at: American Society of Nephrology Kidney Week 2024; October 23-27, 2024; San Diego, CA. FR-PO851.
- Ravipati P et al. Poster presented at: American Society of Nephrology Kidney Week 2024; October 23-27, 2024; San Diego, CA. FR-PO906.
MA-SP-25-0113 | September 2025