Abstract: SA-PO0889
Real-World Data on Low Proteinuria with Sparsentan (SPAR) in Patients (Pts) with IgAN: A Case Series
Session Information
- Glomerular Case Reports: ANCA, IgA, IgG, and More
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Hsu, Raymond K., University of California, San Francisco, California, United States
- Choi, Grace, Cedars-Sinai Health System, Los Angeles, California, United States
- Izutsu, Christie H., University of Hawaii, Honolulu, Hawaii, United States
- Kamgar, Mohammad, University of California, Los Angeles, California, United States
- Nobakht, Niloofar, University of California, Los Angeles, California, United States
- Parmakhtiar, Basmina, Travere Therapeutics, Inc., San Diego, California, United States
- Pelts Block, Agness, Travere Therapeutics, Inc., San Diego, California, United States
- Wiegley, Nasim, University of California, Davis, Sacramento, California, United States
Introduction
SPAR is a non-immunosuppressive, dual endothelin angiotensin receptor antagonist (DEARA) approved in the US and EU for adults with IgAN. In PROTECT, SPAR was well tolerated (95% of pts received the target dose [400 mg/d]) and lowered proteinuria, leading to complete remission (CR) of proteinuria more often vs maximum labeled dose irbesartan. However, evidence on the antiproteinuric effect of SPAR in the real-world setting is limited. Here, we report the clinical features and treatment (tx) responses of 14 pts with IgAN receiving SPAR in the real-world setting.
Case Description
Fourteen pts with biopsy-proven IgAN (aged ≈25-75 y) received SPAR (tx duration, 2-18 mo). SPAR was initiated between 1 mo and ≈13 y post diagnosis. Individual cases are summarized in the Table. Proteinuria (urine protein-to-creatinine ratio [UPCR]) decreased in all pts after SPAR initiation. UPCR <0.5 g/g and <0.3 g/g (CR) were achieved in 11/14 and 4/14 pts, respectively, including in pts who did not reach UPCR <0.5 g/g with prior txs (including systemic steroids, TRF-budesonide, and SGLT2i). Of 10 pts who received SPAR and ongoing SGLT2i, additional proteinuria reductions were observed following SPAR initiation, with 8 reaching UPCR <0.5 g/g and 3 reaching CR. Of 5 pts who had UPCR <1 g/g at SPAR initiation, all pts achieved UPCR <0.5 g/g. SPAR was generally well tolerated, with no discontinuations due to safety concerns. In 3 pts with intolerance to the 400-mg/d dose, dose modification (200 mg/d or alternating 200 mg/400 mg every other day) was well tolerated, with effective proteinuria control (UPCR <0.5 g/g).
Discussion
This case series supports the benefit of SPAR, alone or in combination with other txs, on achieving clinically meaningful low proteinuria thresholds, including CR, with real-world use in pts with IgAN.