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Abstract: SA-PO0888

Case Series of Proteinuria Reduction with Sparsentan (SPAR) Combined with SGLT2 Inhibitors (SGLT2is) in Adults with IgAN at a Single Site

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Mehta, Ankit, Internal Medicine, Baylor University Medical Center, Dallas, Texas, United States
  • Borda Sanchez, Gustavo Alfonso, Nephrology Department, Baylor University Medical Center, Dallas, Texas, United States
  • Willcockson, Alexandra, Travere Therapeutics, Inc., San Diego, California, United States
  • Pelts Block, Agness, Travere Therapeutics, Inc., San Diego, California, United States
Introduction

SPAR is a non-immunosuppressive, dual endothelin angiotensin receptor antagonist (DEARA) that is approved in the US and EU for adults with IgAN. Interim analyses of SPARTACUS and the ongoing PROTECT open-label extension showed an additive benefit in proteinuria reduction when SPAR is used with SGLT2i therapy. Here, we report a series of 8 adults with IgAN who received SPAR+SGLT2i.

Case Description

Eight patients with IgAN received SPAR (target dose: 400 mg/d) in combination with SGLT2i therapy (Table). Most patients (88%) received prior angiotensin-receptor blockers (ARBs), which were discontinued prior to SPAR initiation. Duration of follow-up on SPAR+SGLT2i ranged from 2 to 16 mo. SPAR+SGLT2i led to reductions in proteinuria in 7/8 (88%) patients. These reductions were observed regardless of proteinuria level at SPAR initiation or prior treatment history. SPAR+SGLT2i therapy was generally well-tolerated with no observed liver function test elevations. At last follow up, only 1 patient had discontinued SPAR due to change in insurance coverage after which proteinuria levels increased.

Discussion

These cases show real-world experience of proteinuria reduction when SPAR is used with SGLT2i treatment in adults with IgAN, even in patients who previously tried immunosuppressive therapy or ARB standard of care. SPAR+SGLT2i was generally well-tolerated with no new safety signals.

Digital Object Identifier (DOI)