Filspari (sparsentan) / Travere Therap, Ligand, CSL Behring - LARVOL DELTA

Sparsentan for Halting Renal Disease Progression in Transplant Recipients with Recurrent IgA Nephropathy (WTC 2025) - "Maintenance immunosuppression included mycophenolate mofetil, tacrolimus, and prednisone. The stability in renal function on Sparsentan proves its efficacy even in kidney transplant recipients and should be considered more frequently in cases of IgAN recurrence post-transplant."

Clinical • Acute Kidney Injury • Cardiovascular • Glomerulonephritis • Hypertension • IgA Nephropathy • Infectious Disease • Lupus Nephritis • Nephrology • Novel Coronavirus Disease • Renal Disease • Transplantation • EDN1

Sparsentan, a Novel Dual Endothelin Angiotensin Receptor Antagonists (DEARAs) for Post Transplant Proteinuria - A Single Center Outcomes Analysis (WTC 2025) - "Proteinuria in KTR is a risk factor that impacts patient and graft survival. Dual Endothelin Angiotensin receptor antagonists (DEARA) may represent a novel therapy to reduce proteinuria post Tx. Our study of Sparsentan in patients observed under a strict FDA mandated REMS protocol demonstrated a significant proteinuria reduction in most patients with over 40 % achieving complete remission."

Clinical • Post-transplantation • Cardiovascular • Glomerulonephritis • IgA Nephropathy • Renal Disease • Transplantation

Recurrent IgA Nephropathy in a Kidney Transplant Recipient Treated with Sparsentan (WTC 2025) - "IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide and is associated with a significant risk of end-stage renal disease. A common manifestation includes episodic hematuria following an upper respiratory tract infection. The degree of proteinuria has been established as the best measure of disease progression and response to treatment."

Clinical • Cardiovascular • Glomerulonephritis • Hypertension • IgA Nephropathy • Infectious Disease • Lupus Nephritis • Nephrology • Pulmonary Arterial Hypertension • Pulmonary Disease • Renal Disease • Respiratory Diseases • Transplantation

Targeted Therapy for De Novo IgA Nephropathy in a Kidney Transplant Recipient: A Case Report and Emerging Therapeutic Strategies (WTC 2025) - "This case highlights the potential of targeted therapies in treating de novo IgAN post-transplant. The combination of budesonide and sparsentan resulted in significant proteinuria reduction and stabilization of allograft function. Future research should focus on expanding on the role and benefits of these agents."

Case report • Clinical • Cardiovascular • Chronic Kidney Disease • Glomerulonephritis • Hypertension • IgA Nephropathy • Nephrology • Renal Disease • Transplant Rejection • Transplantation

Expanding the Donor Pool; Utilization of Kidneys from Donors with Lupus Nephritis - Case Report and Review of Literature (WTC 2025) - "We present our successful outcome of transplanting a kidney from a donor with Lupus related Nephrotic syndrome inducing a post Tx remission with Sparsentan therapy. Literature review of others experience like our case suggests that with careful selection - kidneys from donors with lupus nephritis can be successfully transplanted, potentially expanding the donor pool."

Case report • Clinical • Review • Atherosclerosis • Chronic Kidney Disease • Glomerulonephritis • Immunology • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology

Sparsentan in IgA nephropathy: a plain language summary of publication for the PROTECT study. (PubMed, Ther Adv Rare Dis) - "The original article reported on how well sparsentan worked to lower proteinuria and slow the worsening of kidney function (measured by estimated glomerular filtration rate (eGFR)) in people with IgA nephropathy compared with the highest possible dose of irbesartan over an approximately 2-year treatment period. The article also described the side effects that people enrolled in this study had with either sparsentan or irbesartan."

Journal • Review • Glomerulonephritis • IgA Nephropathy • Nephrology • Renal Disease

Safety of Drugs in Breastfeeding Women With CKD. (PubMed, Kidney Int Rep) - "Among renin-angiotensin system inhibitors, enalapril and captopril are safe for breastfeeding. Based on limited evidence, quinapril, benazepril, candesartan, and valsartan are likely acceptable for use during breastfeeding. We found no compelling human data regarding the safety of other renin-angiotensin system inhibitors or sodium-glucose cotransporter type 2 (SGLT2) inhibitors, finerenone, sparsentan, or glucagon-like peptide-1 receptor agonists (GLP1RAs) in lactation. Immunosuppressive agents, including azathioprine, cyclosporine, tacrolimus, budesonide, rituximab, and eculizumab are acceptable for use during breastfeeding. Belimumab is most likely safe; however, data are limited...No studies were found on the safety of breastfeeding while on the newer complement inhibitors, including avacopan, ravulizumab, iptacopan, and pegcetacoplan...Human lactation data on the safety of most drugs used in the treatment of CKD are limited, making evidence-based recommendations..."

Journal • Chronic Kidney Disease • Nephrology • Renal Disease

Sparsentan: a dual endothelin and angiotensin II receptor antagonist approved for IgA nephropathy. (PubMed, Expert Rev Clin Pharmacol) - "As an agent that impacts the glomeruli directly, sparsentan is able to limit damage in mechanisms that previous RASi and steroids have not. Including sparsentan in the combination treatment for IgAN must be considered for adequate kidney protection."

Journal • Review • Chronic Kidney Disease • Glomerulonephritis • IgA Nephropathy • Lupus Nephritis • Nephrology • Renal Disease • Transplantation

Efficacy and safety of agents for IgA nephropathy: a network meta-analysis of randomized controlled trials. (PubMed, Front Med (Lausanne)) - "Clinical remission (26 RCTs included in the analysis): The CR for tonsillectomy combined with steroids pulse therapy (TSP) (RR = 8.23, 95% CI 4.11-16.45), anti-APRIL monoclonal antibody sibeprenlimab (RR = 10.00, 1.34-74.48), and steroids combined with renin-angiotensin system inhibitors (STE + RASI) (RR = 5.03, 2.61-9.68) were significantly superior to placebo. Proteinuria control (36 studies assessing 24-h UPE): The BLyS/APRIL dual-target inhibitor telitacicept (SMD = -5.21, -7.55 to -2.87) and STE + RASI (SMD = -1.98, -3.15 to -0.82) significantly reduced 24-h UPE, outperforming the mycophenolate mofetil combined with steroids regimen (SMD = -0.97, -2.74 to 0.80)...Safety (36 studies reporting adverse events): The complement inhibitor iptacopan (88.4%) and sodium-glucose co-transporter 2 inhibitors (SGLT2i) (85.4%) had the lowest incidence of adverse events, significantly better than immunosuppressive regimens...Telitacicept, sparsentan, and TSP can be considered as..."

Journal • Retrospective data • Review • Chronic Kidney Disease • Glomerulonephritis • IgA Nephropathy • Nephrology • Renal Disease

Advances in the pathophysiology and treatment of focal segmental glomerulosclerosis: The importance of a timely and tailored approach. (PubMed, World J Nephrol) - "Advances include novel biomarkers, genetic testing, and innovative therapeutics such as transient receptor potential ion channel blockers and antisense oligonucleotides for apolipoprotein 1-related FSGS. Effective management of FSGS requires a combination of timely diagnosis, evidence-based therapeutic strategies, and ongoing research to optimize patient outcomes and address gaps in the current understanding of the disease."

Journal • Chronic Kidney Disease • CNS Disorders • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Lupus Nephritis • Nephrology • Renal Disease

Clinical study outcomes in IgA nephropathy: A systematic literature review and narrative synthesis. (PubMed, PLoS One) - P3 | "Until recently, the evidence has been mixed or inconsistent across studies for the efficacy of IgAN treatments in reducing proteinuria or slowing eGFR decline due to a high risk of bias in many included studies. The latest large, phase 3 NefIgArd (NCT03643965) and PROTECT (NCT03762850) clinical trials have demonstrated a meaningful reduction in proteinuria and eGFR decline for patients with IgAN receiving targeted-release formulation budesonide (TRF-B) or sparsentan. Results from other high-quality randomized controlled trials with a follow-up period of at least 2 years are still required to better support advancements in the management of IgAN."

Journal • Review • Glomerulonephritis • IgA Nephropathy • Inflammation • Nephrology • Renal Disease

Patients With Focal Segmental Glomerulosclerosis (FSGS) Achieved Low Proteinuria Targets Earlier and More Often With Sparsentan (SPAR) vs Irbesartan (IRB) in DUPLEX (ERA 2025) - P3 | "Clinically meaningful low proteinuria thresholds and partial and complete remission definitions were achieved earlier and more often with SPAR vs IRB. In DUPLEX, the risk of KF was lower among patients who achieved partial or complete remission of proteinuria vs those who did not. Taken together, results support the nephroprotective benefit of SPAR in patients with FSGS."

Clinical • Chronic Kidney Disease • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Renal Disease

Antiproteinuric effect of SGLT2 inhibitors in non-diabetic glomerulopathies is dependent on body mass index. (ERA 2025) - "Subgroup analysis of EMPA-KIDNEY and DAPA-CKD trials done in patients with glomerular diseases [IgA Nephropathy (IgAN) and focal and segmental glomerulosclerosis (FSGS)] showed these agents are less effective in reducing proteinuria compared to other agents like Sparsentan, or Double RAS Blockade... The principal finding of the present study is the lack of significant proteinuria reduction in patients with BMI<25 kg/m², which contrasts with the significant reductions observed in overweight and obese patients. SGLT2i's main antiproteinuric mechanism of action involves reducing glomerular hyperfiltration, which is commonly seen in patients with diabetes and obesity. In non-diabetic patients with glomerulopathies, proteinuria may be sustained by mechanisms not dependent on glomerular hyperfiltration, especially in those patients with normal BMI."

Chronic Kidney Disease • Diabetic Nephropathy • Focal Segmental Glomerulosclerosis • Genetic Disorders • Glomerulonephritis • IgA Nephropathy • Metabolic Disorders • Obesity • Oncology • Renal Disease

Concomitant Sparsentan and Sodium-Glucose Cotransporter-2 Inhibitors in Adults With IgA Nephropathy in the Phase 2 SPARTACUS Trial (ERA 2025) - "Switching from RASi to SPAR treatment on a background of an SGLT2i allowed for further reduction in proteinuria in adult patients with IgAN, lowering their risk for disease progression. SPAR combined with an SGLT2i was generally well tolerated, with no unexpected safety signals"

Clinical • P2 data • Chronic Kidney Disease • Glomerulonephritis • Hypotension • IgA Nephropathy • Renal Disease

Real-World Treatment Patterns of Patients with Immunoglobulin A Nephropathy (IgAN) in the United States (ERA 2025) - "Outcomes included the proportion of patients receiving IgAN therapies approved during the identification period, including renin–angiotensin–aldosterone system inhibitors (RAASi), immunosuppressants (IS), sodium-glucose cotransporter-2 inhibitors (SGLT2i), targeted-release budesonide (TRB), and sparsentan (SPAR); the proportion of patients discontinuing treatment; and treatment duration. These real-world data show that approximately two-thirds of patients with IgAN received treatment for their disease. Almost all treated patients received RAASi, and for almost half of this population, it was the only treatment received during follow-up. Use of the newer IgAN- specific therapies was low in this study population, though their approval timings relative to the study period must be considered."

Clinical • HEOR • Real-world • Real-world evidence • Fibrosis • Focal Segmental Glomerulosclerosis • Glomerulonephritis • IgA Nephropathy • Immunology • Lupus Nephritis • Renal Disease

Sparsentan reduces glomerular dysfunction and proteinuria in a rat model of serum-factor-induced nephrotic syndrome (ERA 2025) - "We have shown that the DEARA sparsentan, reduces glomerular permeability and proteinuria in a rat model of serum factor-induced podocytopathy. These findings suggest that the action of sparsentan on the GFB could help maintain barrier integrity in podocytopathic proteinuric kidney diseases."

Preclinical • Focal Segmental Glomerulosclerosis • Glomerulonephritis • IgA Nephropathy • Nephrology • Renal Disease • ALB

Effects of Sparsentan After Maximized Angiotensin Receptor Blocker (ARB) Treatment in Patients With IgA Nephropathy (IgAN) in the PROTECT Trial (ERA 2025) - "These data support the marked efficacy and tolerability of sparsentan in patients with IgAN who had previously received over 2 years of fully titrated maximum tolerated ARB therapy during the PROTECT trial."

Clinical • Glomerulonephritis • IgA Nephropathy • Renal Disease

Sparsentan reversibly decreases mesangial IgA deposition in gddY mice; a possible role for mesangial-cell -surface autoantigen expression. (ERA 2025) - "The increase in HMC-surface β2-spectrin and CBX3 expressions following incubation with ET-1 and AngII may play a role in the observation that SP900 significantly attenuated mesangial IgA deposition in gddY mice following 12 wks of treatment without alterations in sIgA or glycocalyx. Further studies are required to understand the mechanisms behind these novel findings."

Preclinical • Glomerulonephritis • IgA Nephropathy • CBX3 • EDN1

Clinical Practice Gaps in the Diagnosis and Management of Immunoglobulin A Nephropathy (ERA 2025) - " •395 nephrologists completed all questions within the data collection timeframe •76% of nephrologists saw between 1 and 10 patients per month with IgAN •38% failed to recognise that the RaDaR study showed that IgAN is progressive even in patients thought to be at low risk (proteinuria < 1 g/d) •17% could not correctly identify that the most common clincial presentation of IgAN is asymptomatic microscopic hematuria and proteinuria •44% did not recognise the presence of tubular atrophy (T), a finding of the MEST-C score, is a consistent, independent predictor of worse outcomes in patients with IgAN •34% did not identify the correct order of the multihit hypothesis of the pathophysiology of IgAN •Only 21% knew that production of Gd-IgA1 is a mechanism via which the cytokines a proliferation inducing ligand (APRIL) and B-cell activating factor (BAFF) drive IgAN pathogenesis •66% did not recognise that, according to 2021 KDIGO guidelines, considering enrollment in a..."

Clinical • Chronic Kidney Disease • Glomerulonephritis • IgA Nephropathy • Renal Disease

Implications of proteinuria remission on estimated glomerular filtration rate (eGFR) trajectory in patients with IgA nephropathy in the PROTECT trial (UKKW 2025) - "Background : In PROTECT, sparsentan (SPAR) reduced proteinuria and increased the proportion of patients achieving complete proteinuria remission (CR; urine protein excretion [UPE] <0.3 g/day) (31%) vs irbesartan (IRB) (11%). In IgAN, achievement of low proteinuria is strongly predictive of better long-term kidney function. eGFR preservation was more evident in patients who achieved low proteinuria vs those who did not; notably, in patients who achieved CR, the mean rate of kidney function decline (eGFR chronic slope) was <1.0 mL/min/1.73 m2/year. As SPAR-treated patients achieved proteinuria remission more frequently vs IRB in PROTECT, this analysis further supports the benefit of SPAR for long-term preservation of kidney function."

Clinical • Glomerulonephritis • IgA Nephropathy • Renal Disease

Concomitant sparsentan (SPAR) and SGLT2 inhibitors in patients with IgA nephropathy in the PROTECT open-label extension (OLE) (UKKW 2025) - "Background : SPAR, a non-immunosuppressive, dual endothelin angiotensin receptor antagonist (DEARA), demonstrated superior efficacy for proteinuria reduction and better preservation of kidney function vs irbesartan in patients with Immunoglobulin A nephropathy (IgAN) in the PROTECT trial. These data show that an SGLT2i added to a stable dose of SPAR is generally well tolerated and may lead to further reductions in proteinuria. The safety and efficacy of sparsentan with or without concomitant SGLT2i treatment are also being investigated in a separate randomised sub-study within the PROTECT OLE."

Clinical • Cardiovascular • Glomerulonephritis • Hypertension • Hypotension • IgA Nephropathy • Infectious Disease • Novel Coronavirus Disease • Renal Disease

Concomitant sparsentan (SPAR) and SGLT2 inhibitors in adults with IgA nephropathy in the ongoing phase 2 SPARTACUS trial (UKKW 2025) - "Enrolment in SPARTACUS will allow for assessment of the efficacy and safety of SPAR added to a stable SGLT2i in patients with IgAN. The poster will include data from the interim analysis."

Clinical • P2 data • Chronic Kidney Disease • Glomerulonephritis • IgA Nephropathy • Renal Disease

Sparsentan (SPAR) as first-line treatment of incident patients with IgA nephropathy: interim analysis of the SPARTAN trial (UKKW 2025) - P2 | "In patients newly diagnosed with IgAN, interim findings show that SPAR as first-line treatment was generally well tolerated and led to rapid and sustained reductions in proteinuria by approximately 70% over 24 weeks, with reductions in urinary sCD163 indicative of a direct anti- inflammatory effect."

Clinical • Glomerulonephritis • Hypotension • IgA Nephropathy • Renal Disease • CD163

Quantifying Spillover Impacts: Effect of Novel Therapies for IgA Nephropathy on Patients Awaiting Kidney Transplant (ISPOR 2025) - "IgAN interventions included therapies with FDA approval or phase 3 proteinuria reduction results (targeted-release budesonide, sparsentan, iptacopan, dapagliflozin, and atrasentan) in addition to nonspecific IgAN therapies (including renin-angiotensin-aldosterone system inhibitors and systemic corticosteroids); the comparator was nonspecific IgAN therapies alone. IgAN interventions may provide health benefits beyond the direct clinical benefits to affected patients. These additional societal benefits should be considered when conducting value assessment of novel IgAN treatments."

Clinical • Chronic Kidney Disease • Glomerulonephritis • IgA Nephropathy • Lupus Nephritis • Nephrology • Renal Disease • Transplantation

Interventions for idiopathic steroid-resistant nephrotic syndrome in children. (PubMed, Cochrane Database Syst Rev) - "Calcineurin inhibitors may increase the likelihood of complete or partial remission compared with placebo/no treatment or cyclophosphamide. For other regimens, it remains unclear whether the interventions alter outcomes because the certainty of the evidence is low. Further adequately powered, well-designed RCTs are needed to evaluate other regimens for children with idiopathic SRNS. Since SRNS represents a spectrum of diseases, future studies should enrol children from better-defined groups of people with SRNS."

Clinical • Journal • Review • Cardiovascular • Dermatology • Glomerulonephritis • Hypertension • Infectious Disease • Nephrology • Pediatrics • Renal Disease • Transplantation