Can sparsentan treat primary IgA nephropathy and its efficacy evaluation

Sparsentan is a new oral dual receptor antagonist that simultaneously blocks angiotensin II receptor type 1 (AT1) and endothelin receptor A (ETA). The drug reduces glomerular hypertension, inhibits inflammatory response and renal fibrosis through dual action mechanisms, thereby reducing proteinuria and delaying the decline of renal function. Unlike traditional single-target drugs (such as irbesartan), sparsentan has more significant potential advantages in improving glomerular microcirculation and maintaining glomerular filtration rate.

In the international phase III clinical study (PROTECT trial) for the treatment of primary IgA nephropathy, sparsentan showed superior efficacy to conventional RAAS inhibitors. The results of the study showed that the urine protein/creatinine ratio of patients treated with sparsentan decreased by approximately 50% on average within 36 weeks, which was significantly higher than that of the irbesartan group (a decrease of approximately 15%-20%). In addition, patients' glomerular filtration rate (eGFR) declined more slowly, suggesting the drug's clinical value in delaying the progression of IgA nephropathy.

Clinical data show that sparsentan is generally well tolerated. Common adverse reactions include mild hypotension, elevated serum potassium, and edema, and are mostly controllable and reversible reactions. Compared with traditional protein-lowering drugs, the incidence of adverse reactions of this drug is slightly lower, but blood pressure, electrolytes and renal function indicators still need to be monitored. Doctors generally advise patients to avoid taking it with other RAAS inhibitors to reduce the risk of impaired kidney function or hyperkalemia.
Sparsentan is currently approved in the United States for the treatment of IgA nephropathy and focal segmental glomerulosclerosis (FSGS), and is considered a new breakthrough in the treatment of IgA nephropathy. The drug can effectively reduce proteinuria and delay the progression of renal failure, providing a new treatment option for patients whose condition cannot be controlled by traditional drugs. With the subsequent accumulation of more real-world data, sparsentan is expected to be approved for marketing in China, bringing more precise and longer-lasting treatment options to patients with IgA nephropathy.
Reference: https://www.drugs.com/