Summary: In this multi-center, double-blind, randomized control study, a total of 724 pediatric and adult patients were selected and randomized (sparsentan vs. irbesartan).  End points included eGR slopes and urine protein/creatinine ratios.  At the end of the study, all proteinuria based end points favored sparsentan.  At 108 weeks, there were no significant differences in GFR slopes between sparsentan and irbesartan.  Patients in the sparsentan group had significant initial decline in GFR.  The safety profile of sparsentan and irbesartan were similar.

Objectives:

At the conclusion of this activity, the learner should be able to:

• Identify potential treatment strategies for FSGS.
• Determine sparsentan’s utility as compared to irbesartan.
• Recall that GFR decline and proteinuria is associated with disease progression. 
• Recognize that sparsentan is not a disease-specific medication.  It is also used in IgA nephropathy.

Bibliography:

• Sparsentan versus Irbesartan in Focal Segmental Glomerulosclerosis. Alpers et al., NJEM. Nov 2023.
• Therapeutic trials in adult FSGS: lessons learned and the road forward. De Vriese et al., Nature. Sept 2021.
• Sparsentan in patients with IgA nephropathy: a prespecified interm analysis from a randomized, double-blind, active control clinical trial. Heerspink et al., The Lancet. Apr 2023.
• Focal Segmental Glomerulosclerosis. Rosenberg and Kopp., CJASN. Mar 2017.

Attendance/Credit
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TRANSCRIPT
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