What kind of nephritis does sparsentan/sparsentan treat?

Sparsentan is an antagonist of endothelin type A receptor (ETAR) and angiotensin type II receptor (AT1R). It is mainly used to treat primary immunoglobulin A nephropathy. The drug provides a multi-target treatment plan by combining two different mechanisms, which has a significant effect on improving patients' renal function and reducing proteinuria.

Sparsentan is approved for use in reduction of primary immunoglobulin A nephropathy (IgAN) in adults with a risk of rapid disease progression, usually with a urine protein/creatinine ratio (UPCR) ≥1.5g/g, and is designated as an orphan drug by the U.S. Food and Drug Administration (FDA) for this purpose. Approved under accelerated approval based on reduction in proteinuria.

Treatment of IgAN includes supportive care, lifestyle changes (exercise, weight control, smoking cessation, dietary sodium restriction), cardiovascular risk reduction interventions, and blood pressure management; pharmacotherapy may include ACE inhibitors, angiotensin receptor blockers (ARBs), and/or immunosuppressive therapy. Sparsentine's exact place in treatment has not yet been determined.

Sparsentan is a dual-action drug. Research shows that angiotensin II plays an important role in kidney disease. It can cause the contraction of renal tubules and accelerate the fibrosis process, thereby inducing further deterioration of kidney function. By inhibiting this process, sparsentine helps reduce the pressure and burden on the renal tubules and promotes kidney repair and functional recovery. Sparsentine also has anti-inflammatory and immunomodulatory properties, which are particularly important in managing nephritis associated with immune responses. In many cases of primary nephritis, inappropriate activation of the immune system may lead to damage to kidney tissue, and sparsentine helps suppress this inappropriate response by regulating the immune response, thereby reducing the inflammatory response and protecting the health of kidney cells.