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

Empiric Treatment of Suspected De Novo Glomerular Disease in the Third Trimester of Pregnancy (KIDNEY WEEK 2026) - "Preexisting primary hypertension was managed with labetalol and amlodipine during pregnancy...She completed a prednisone taper and was later placed on budesonide, sparsentan, and dapagliflozin with benefit...Maternal effects can include weight gain, hypertension, and diabetes. The benefit of limiting pregnancy complications and maternal kidney function loss from active GN outweighed these risks."

Acute Kidney Injury • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Depression • Diabetes • Diabetic Nephropathy • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Gynecology • Hypertension • IgA Nephropathy • Immunology • Inflammatory Arthritis • Lupus • Lupus Nephritis • Metabolic Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Nephrology • Obstetrics • Orthopedics • Pulmonary Disease • Renal Disease • FLT1

Sparsentan in APOL1-Mediated Kidney Disease: A DUPLEX Post Hoc Signal and Trial Roadmap (KIDNEY WEEK 2026) - "While inaxaplin offers a targeted APOL1 approach, complementary downstream strategies remain limited...In the phase 3 DUPLEX trial, sparsentan showed sustained proteinuria reduction versus irbesartan, earning April 2026 FDA approval for FSGS...Conclusion The DUPLEX post-hoc signal, though limited, supports formal evaluation of sparsentan through an APOL1-stratified trial to define its role in dual pathway blockade. Beyond therapeutics, this framework illustrates the importance of genotype-stratified design in addressing trial representation gaps."

Retrospective data • Chronic Kidney Disease • Fibrosis • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Immunology • Inflammation • Nephrology • Renal Disease • EDN1

Association Between Achievement of Low-Proteinuria Thresholds and Health-Related Quality of Life in FSGS: Pooled DUET and DUPLEX Analysis (KIDNEY WEEK 2026) - P2, P3 | "Background Building on the positive outcomes observed in DUET (NCT01613118), in DUPLEX (NCT03493685), patients with focal segmental glomerulosclerosis (FSGS) achieved low proteinuria thresholds earlier and more often with sparsentan, a dual endothelin and angiotensin II receptor antagonist (DEARA), compared to maximum labeled dose irbesartan. These associations highlight the importance of achieving meaningful reductions in proteinuria for patients with FSGS. Improvement in HRQoL Domain Score by Achievement of Proteinuria Threshold"

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

Sparsentan for Recurrent IgAN After Kidney Transplantation (KIDNEY WEEK 2026) - "Losartan was discontinued and sparsentan was initiated. Key considerations include monitoring drug-induced hepatotoxicity, and potential pharmacokinetic interactions with tacrolimus via shared CYP3A4 metabolism. Further study is required."

Fibrosis • Glomerulonephritis • Hepatitis B • Hepatitis C • Hepatology • IgA Nephropathy • Immunology • Infectious Disease • Inflammation • Transplantation • CYP3A4

Composite Kidney Failure End Points in Contemporary Phase 3 Randomized Controlled Trials of Novel Therapies for IgAN: A Systematic Review and Meta-Analysis Stratified by Mechanism of Action (KIDNEY WEEK 2026) - "Subgroup analyses were performed stratified by mechanistic class: intestinal/mucosal immunosuppression (targeted-release budesonide, methylprednisolone), complement factor B inhibition (iptacopan), and dual RAAS/endothelin antagonism (sparsentan). Conclusion Contemporary phase 3 IgAN therapies across distinct mechanistic classes consistently reduce composite kidney failure risk by approximately 48% relative to control. Low heterogeneity suggests that the composite KF endpoint captures a shared final common pathway amenable to therapeutic modification regardless of upstream target."

P3 data • Retrospective data • Review • Chronic Kidney Disease • Glomerulonephritis • IgA Nephropathy • Nephrology • Renal Disease • CFB

Real-World Use and Clinical Outcomes with Sparsentan in the United Kingdom (UK) and Germany (KIDNEY WEEK 2026) - "In the PROTECT study, SPAR resulted in significant proteinuria reduction and kidney function preservation compared with maximum labeled dose irbesartan in adults with IgAN. Conclusion Pts with IgAN receiving SPAR experienced clinically relevant reductions in UPCR and stabilized eGFR. Real-world experience indicates that SPAR is an effective treatment option with good adherence in clinical practice."

Clinical • Clinical data • Real-world • Real-world evidence • Chronic Kidney Disease • Glomerulonephritis • IgA Nephropathy • Nephrology • Renal Disease

Efficacy of Sparsentan in FSGS: A Meta-Analysis of Randomized Clinical Trials (KIDNEY WEEK 2026) - "Early eGFR decline was numerically greater with sparsentan, with no statistically significant (mean difference −4.2 mL/min/1.73 m 2; p=0.28). Conclusion Sparsentan showed promising efficacy in FSGS patients, with greater reductions in proteinuria and BP compared with irbesartan, with acceptable safety profile, providing a benchmark for future studies."

Retrospective data • Chronic Kidney Disease • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Renal Disease

Emerging Targeted Therapies in IgAN: A Systematic Review Without Meta-Analysis (SWiM) of Phase 3 Randomized Controlled Trials (KIDNEY WEEK 2026) - "All treatments reduced UPCR versus control groups: 27% for Nefecon at 9 months, 51.2% for sibeprenlimab at 9 months, 38.3% iptacopan at 9 months, 36.1% for atrasentan at 36 weeks, and 41% for sparsentan at 36 weeks (all 95% confidence intervals exclude zero)...Sparsentan was associated with reduction in chronic eGFR slope versus irbesartan (1.1 mL/min/1.73m2/yr), although total slope did not reach statistical significance...Conclusion The five phase 3 RCTs of targeted therapies in IgAN demonstrated reductions in proteinuria and, in several trials, slowing of eGFR decline, supporting potential disease-modifying effects. However, interpretation is limited by reliance on surrogate endpoints, and longer-term follow-up is needed to confirm effects on kidney failure and safety outcomes."

P3 data • Retrospective data • Review • Glomerulonephritis • IgA Nephropathy • Infectious Disease • Nephrology • Renal Disease

Real-World Reasons for Discontinuation of Targeted-Release Budesonide in IgAN (KIDNEY WEEK 2026) - "Background therapies: 81% RAS-blocker, 69% SGLT2-inhibitor, 13% sparsentan. Conclusion In our small but growing cohort, lack of efficacy in either proteinuria reduction or eGFR stabilization was a major reason for TR-budesonide discontinuation. Side effects that would not be considered major adverse events in clinical trials such as minor weight gain and moon facies also contributed to stopping therapy."

Clinical • Real-world • Real-world evidence • Glomerulonephritis • IgA Nephropathy • Renal Disease

Real-World Characteristics of Patients with IgAN Receiving Combination Therapy: A Retrospective Claims Analysis (KIDNEY WEEK 2026) - "Methods This retrospective cohort study included adults (aged ≥18 years) who initiated ≥2 FDA-approved IgAN-specific therapies—targeted-release budesonide, sparsentan, iptacopan, and atrasentan—within 60 days of each other in the Komodo Healthcare Map™ database (Feb 1, 2023–Dec 4, 2025). Conclusion This study provides real-world evidence on characteristics of pts receiving a combination of IgAN-specific therapies, demonstrating the increasing adoption of multi-mechanistic treatment strategies in clinical practice. These findings align with KDIGO guideline recommendations emphasizing simultaneous targeting of complementary disease pathways in IgAN."

Combination therapy • Real-world • Real-world evidence • Retrospective data • Fibrosis • Focal Segmental Glomerulosclerosis • Glomerulonephritis • IgA Nephropathy • Immunology

Real-World Adherence to Oral Therapies in IgA Nephropathy (KIDNEY WEEK 2026) - "Five non-mutually exclusive cohorts were defined by oral therapy class: Budesonide, Sparsentan, Iptacopan, ACEi/ARBs, and SGLT2is. Conclusion Medication adherence to oral therapies in IgAN was suboptimal in real-world settings, approximately half the patients met the adherence threshold. Lower adherence was associated with higher HCRU, highlighting an unmet need for alternative options to improve adherence."

Adherence • Clinical • HEOR • Real-world • Real-world evidence • Cardiovascular • Chronic Kidney Disease • Glomerulonephritis • Hypertension • IgA Nephropathy • Inflammation • Rare Diseases • Renal Disease

Practice Variability and Individualized Treatment Selection in IgAN in the Era of Emerging Therapies (KIDNEY WEEK 2026) - "Results A review of five patients with biopsy-proven IgAN demonstrated significant variability in treatment approach utilizing SGLT2i, Sparsentan, and Sibeprenllimab (Figure 1a)...Regarding the preferred escalation therapy: 42.9% of participants selected combination therapy, 42.9% SGLT2i, and 14.3% Tarpeyo...50% considered persistent proteinuria, 33.3% prioritized rapid disease progression, and 16.7% high risk biopsy findings Conclusion Real-world management of IgAN shows substantial variability in treatment selection and escalation strategies among nephrologists. Development of standardized risk stratification models integrating clinical and histological factors is needed to guide combination therapy strategy and individualized treatment in IgAN"

Clinical • Glomerulonephritis • IgA Nephropathy • Renal Disease

Medicare Prescription Drug Coverage of Medications for IgAN (KIDNEY WEEK 2026) - "Medications evaluated included: SGLT2 inhibitors (dapagliflozin, Invokana (canagliflozin), Jardiance (empagliflozin), and Steglatro (ertugliflozin)), Fabhalta (iptacopan), Tarpeyo (budesonide), Vanrafia (atrasentan), Voyxact (sibeprenlimab-szsi), and Filspari (sparsentan). Interventions to improve medication access are warranted. MA-PD Plan Coverage"

Medicare • Reimbursement • US reimbursement • Chronic Kidney Disease • Glomerulonephritis • IgA Nephropathy • Nephrology • Renal Disease

Combination Therapy in IgAN: A Real-World Case Demonstrating Rapid Reduction in Proteinuria (KIDNEY WEEK 2026) - "This case highlights the benefit of a combination therapy approach with SGLT2i, endothelin blockade (Sparsentan), and disease-modifying therapy targetin APRIL (Sibeprenlimab) in patients with IgAN and high risk of progression despite optimization of supportive care. Progression of IgAN 89% reduction of proteinuria in 3 months with combination therapy approach Stabilization of creatinine with combination therapy approach"

Clinical • Combination therapy • Real-world • Real-world evidence • Cardiovascular • Chronic Kidney Disease • Glomerulonephritis • Hypertension • IgA Nephropathy • Nephrology • Obesity • Renal Disease

Real-World Experience of Sequential Targeted-Release Formulation (TRF)-Budesonide and Sparsentan Therapy in Patients with IgAN: A Case Series (KIDNEY WEEK 2026) - "Empagliflozin was initiated in July 2021 with an initial UPCR decrease to 0.9 g/g, which subsequently rebounded to the 2.0 g/g...Sparsentan was initiated, with UPCR decreasing to 1.1 g/g within one month, and further declined to 0.4 g/g Case 2: A 40 y.o. male with IgA vasculitis (IgAV) and IgAN was initially treated with prednisone and achieved remission...The rapid expansion of approved therapies for IgA nephropathy has shifted the clinical challenge toward identifying the right treatment for each patient. This case series offers valuable real-world insight into variability in response and tolerability, supporting more informed and individualized therapeutic approach."

Clinical • Real-world • Real-world evidence • Glomerulonephritis • IgA Nephropathy • Renal Disease • Vasculitis

Spatial Transcriptomics Reveals Sparsentan-Associated Remodelling of Complement-Active Renal Niches in IgAN (KIDNEY WEEK 2026) - P2 | "Conclusion Our findings suggest that SPAR modulates complement-associated injury indirectly by reducing the inflammatory and fibrotic microenvironments that sustain alternative complement activation. Spatially organised fibroblast-rich complement niches may represent key tissue compartments linking complement urine biomarkers to progressive renal remodelling in IgAN."

Fibrosis • Glomerulonephritis • IgA Nephropathy • Renal Disease

Dual Endothelin-Angiotensin Receptor Antagonism for Transcriptional Enhanced Associate Domain (TEAD) Inhibitor-Associated Albuminuria: A Case Series (KIDNEY WEEK 2026) - "Sparsentan's anti-proteinuric superiority over irbesartan in the DUPLEX trial (primary FSGS, a canonical podocytopathy) and PROTECT trial (IgAN) supports the relevance of dual ETA/AT1 blockade when conventional RAAS inhibition is insufficient. These cases suggest DEARA use may be a targeted strategy for managing TEAD inhibitor–induced podocytopathy while enabling continuation of anti-tumor therapy."

Clinical • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Hypertension • IgA Nephropathy • Mesothelioma • Nephrology • Renal Disease • Solid Tumor

Urinary Biomarker Data from the PROTECT Study in IgAN Demonstrate Renal Anti-Inflammatory Actions of Sparsentan, Including Reduced Macrophage, Complement, and B-Cell Activation Signals (KIDNEY WEEK 2026) - P3 | "Approval was based on PROTECT (NCT03762850), which showed superior proteinuria reduction and kidney function preservation over 2 years vs maximum labeled dose irbesartan (IRB). These reductions were statistically significantly greater than those seen with maximum labeled dose IRB across all 4 urinary biomarkers. Conclusion SPAR showed rapid and sustained reductions in urinary biomarkers of inflammation, BAFF, and inhibition of complement activation vs maximum labeled dose IRB in patients with IgAN in PROTECT, indicating anti-inflammatory benefits of targeting endothelin and angiotensin pathways in the treatment of IgAN."

Biomarker • Glomerulonephritis • IgA Nephropathy • Inflammation • Renal Disease • IL6

Effect of Sparsentan on Urine and Plasma Proteome of Patients with IgAN: Findings from the SPARTAN Study (KIDNEY WEEK 2026) - P2 | "Our study supports complement PWY activity reduction as a downstream mechanistic feature of patients’ response to SPAR. Changes in SPAR response - associated urinary complement PWY activity."

Clinical • Glomerulonephritis • Hematological Disorders • IgA Nephropathy • Renal Disease

Proteinuria-Reducing Effect of Sparsentan in Japanese Pediatric and Adult Patients with IgAN: Interim Analysis at Week 36 (KIDNEY WEEK 2026) - "Conclusion Sparsentan reduced proteinuria, preserved kidney function, and was well tolerated in both pediatric and adult Japanese Pts over 36 wks, consistent with the results of the PROTECT study. Percent change from baseline in UPCR using MMRM analysis with imputation (FAS)"

Clinical • Glomerulonephritis • IgA Nephropathy • Nephrology • Pediatrics • Renal Disease

From Proteinuria to Precision Nephrology: Suspected APOL1-Associated FSGS Treated with Early Sparsentan and SGLT2 Inhibition (KIDNEY WEEK 2026) - "Early initiation of combined SGLT2 inhibition and endothelin receptor blockade with sparsentan was associated with marked reduction in proteinuria in four months. This case demonstrated the potential benefit of integrating histopathology, genetics, and contemporary kidney-protective therapies in the management of APOL-1 associated FSGS."

Amyloidosis • Atherosclerosis • Cardiovascular • Chronic Kidney Disease • Diabetic Nephropathy • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Gout • Human Immunodeficiency Virus • Hypertension • Immunology • Infectious Disease • Inflammatory Arthritis • Lupus Nephritis • Nephrology • Renal Disease

KDIGO Spoke, Nephrologists Listened: Treatment Paradigms Are Already Shifting (KIDNEY WEEK 2026) - "During the same period, budesonide, sparsentan, and atrasentan all saw sharp increases in second-line positioning. Conclusion Publication of the final 2025 KDIGO IgAN guideline accelerated earlier and more aggressive treatment strategies, characterized by foundational SGLT2 inhibitor use and expanded adoption of targeted branded therapies. These findings suggest the updated guideline is influencing real-world IgAN treatment choices and reinforcing aggressive and proteinuria-driven management approaches."

Glomerulonephritis • IgA Nephropathy • Renal Disease

T-Cell Large Granular Lymphocytic Leukemia (T-LGL) as a Potential Trigger for Collapsing Glomerulopathy in a Patient with an APOL1 High-Risk Genotype (KIDNEY WEEK 2026) - "Cancer treatment included methotrexate, rituximab, and subsequently clinical trial enrollment. 24 months from presentation, with controlled LGL, has a creatinine 1.4-1.6 mg/dL, proteinuria 2-4 g/day before initiation of sparsentan...Prior reports of paraneoplastic glomerular disease have been limited by lack of genetic testing. In the absence of viral infections or autoimmune disease, a search for underlying hematologic malignancy in patients with collapsing FSGS may be considered."

Clinical • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Hematological Malignancies • Human Immunodeficiency Virus • Immunology • Infectious Disease • Leukemia • Nephrology • Renal Disease • T-Cell Large Granular Lymphocyte Leukemia

Sparsentan Reduces Glomerular IgA Deposition in gddY Mice and Suppresses Mesangial Autoantigen Exposure: Potential Role of cAMP (KIDNEY WEEK 2026) - "± SEM from four independent experiments. One-way ANOVA; ****Padj < 0.0001."

Preclinical • Glomerulonephritis • IgA Nephropathy • Renal Disease • EDN1

Use of Endothelin Receptor Blockade in Patients with IgAN and Advanced CKD: A Case Series (KIDNEY WEEK 2026) - "Sparsentan, a dual endothelin receptor and angiotensin receptor blocker (DEARA), and Atrasentan, a highly selective endothelin A antagonist (ERA), have been shown to reduce proteinuria and eGFR decline in patients with IgAN and an eGFR ≥30 mL/min/1.73 m2. Furthermore, a reduced-dose regimen might be sufficient to mitigate these side effects, as in patient 2. Large randomized controlled trials are needed to validate these observations."

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