Abstract: FR-PO907
Sparsentan (SPAR) in Patients with Prior or Concurrent Immunosuppressive Treatment (IST) for IgA Nephropathy (IgAN): A Case Series
Session Information
- IgA Nephropathy: Clinical, Outcomes, and Therapeutics
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Velez, Luis Eduardo, South Texas Renal Care Group, San Antonio, Texas, United States
- Siva, Reva, Virginia Nephrology Group, Arlington, Virginia, United States
- Pelts Block, Agness, Travere Therapeutics, Inc., San Diego, California, United States
- Gisler, Christopher, Travere Therapeutics, Inc., San Diego, California, United States
- Garcia, Pablo, University of New Mexico School of Medicine, Division of Nephrology, Albuquerque, New Mexico, United States
Introduction
SPAR is a nonimmunosuppressive, dual endothelin angiotensin receptor antagonist (DEARA) approved in the US and EU for the treatment of adults with IgAN. Little is known about the effects of SPAR in patients receiving IST for IgAN. We report a series of 5 cases involving patients with IgAN who received SPAR after previous IST or initiated SPAR in addition to ongoing IST.
Case Description
Five patients with biopsy-proven IgAN (ages 21-71 y) initiated SPAR (400 mg/d; dose increased after 2 weeks at 200 mg/d) after discontinuing IST (n=3; IST discontinued due to insufficient response or completion of treatment course) or in addition to ongoing IST (n=2). Individual case details are summarized in the Table. Duration of follow-up on SPAR ranged from approximately 4 to 6 mo; all patients were receiving ongoing SPAR treatment at last follow-up. A decrease in proteinuria (urine protein-to-creatinine ratio [UPCR]) was seen in all patients after SPAR treatment, regardless of estimated glomerular filtration rate (eGFR) or UPCR at initiation, with 2 achieving complete remission (UPCR <0.3 g/g). Overall, there were no major fluctuations in blood pressure or eGFR decline at follow-up, with an improvement in eGFR seen in 1 patient. Of 4 patients with hematuria at SPAR initiation, hematuria improved in 1 patient and resolved in 2 patients. SPAR was generally well tolerated by these patients. In 1 patient, SPAR treatment was briefly interrupted due to elevated liver function tests but was resumed (initially at 200 then 400 mg/d) without further issue.
Discussion
These cases support the safety and efficacy of SPAR in patients with previous or ongoing IST. Improvements in proteinuria were observed regardless of eGFR or UPCR at SPAR initiation, including in patients in whom target proteinuria was not achieved with IST alone.