Can sparsentin treat proteinuria?

Sparsentan has the effect of protecting glomerular podocytes and reducing proteinuria, and can treat proteinuria. Patients with proteinuria can use this drug for treatment under the guidance of a doctor.

The effect of treating proteinuria

Sparsentan is a novel non-immunosuppressive, single-molecule, dual endothelin and angiotensin receptor antagonist currently being tested in an ongoing Phase 3 clinical trial in adults with IgA nephropathy. Prespecified interim analyzes of the primary proteinuria efficacy endpoint and safety are reported.

Methods: PROTECT was an international, randomized, double-blind, active-controlled study conducted at 134 clinical practice centers in 18 countries. This study compared sparsentan with irbesartan in adults (age ≥18 years) with biopsy-proven IgA nephropathy and proteinuria ≥1.0 g/day despite at least 12 weeks of maximal renin-angiotensin system inhibitor therapy. Participants were randomly assigned in a 1:1 ratio to receive spaxentan 400 mg once daily or irbesartan 300 mg once daily, stratified by estimated glomerular filtration rate at screening (30 to 60 mL/min/1·73 m2 and ≥60 mL/min/1·73 m2) and urinary protein excretion at screening (≤1.75 g/d and ≤1.75 g/d). The primary efficacy endpoint was the change from baseline to week 36 in the urine protein/creatinine ratio based on 24-hour urine samples (assessed using a mixed model with repeated measures). The safety endpoint is the adverse events (teae) that occur during treatment. All endpoints were examined among all participants who received at least one dose of randomized treatment.

Study results: 404 subjects were randomly assigned to receive spasentan (n=202) or irbesartan (n=202). At week 36, the percentage change in the geometric least squares mean of urinary protein to creatinine ratio from baseline in the sparsentan group (-49.8%) was significantly greater than that in the irbesartan group (-15.1%), resulting in a relative decrease of 41% between groups.

CONCLUSIONS: In adults with IgA nephropathy, once-daily treatment with sparsentan significantly reduced proteinuria compared with irbesartan.

Sparsentine and Precautions

The most common adverse reactions of sparsentan, with an incidence rate of ≥5%, are hypotension (including orthostatic hypotension), peripheral edema, dizziness, anemia, and hyperkalemia. If transaminase levels increase during treatment, the patient should adjust the treatment plan under the guidance of a doctor.

Patients should swallow the tablet whole with water before breakfast or dinner. Do not chew or break it. Maintain the same dosing pattern with meals. If a dose is missed, take the next dose at the regularly scheduled time. Do not take double or extra doses.

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