CASE REPORT article
Front. Nephrol.
Sec. Glomerular disease
Volume 5 - 2025 | doi: 10.3389/fneph.2025.1673799
MAXIMIZING THE ANTI-PROTEINURIC RESPONSE: A MULTICENTER REAL-WORLD SPARSENTAN CASE SERIES IN IGA DISORDERS
Provisionally accepted
- 1Creighton University, Omaha, United States
- 2Allina Health, Minneapolis, United States
- 3Mayo Clinic Minnesota, Rochester, United States
- 4UPMC Western Maryland, Cumberland, United States
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Immunoglobulin A Nephropathy (IgAN) is a prevalent form of glomerulonephritis that leads to chronic kidney disease (CKD), typically marked by ongoing proteinuria, even when treated with standard therapies such as renin-angiotensin-aldosterone system (RAAS) blockers and occasionally immunosuppression. Proteinuria is a modifiable risk factor crucial for disease advancement. Sparsentan, a dual endothelin receptor and angiotensin receptor blocker (DEARA), has been introduced as a novel therapeutic option focusing on proteinuria. We present a case series featuring seven patients - five diagnosed with IgAN and two with IgA vasculitis (IgAV) - with severe proteinuria who were treated with Sparsentan, sometimes in combination with other medications such as targeted-release formulation (TRF) budesonide, sodium-glucose cotransporter-2 (SGLT2) inhibitors, or mycophenolate. Notable reductions in proteinuria and improvements in blood pressure regulation were observed in these cases. Sparsentan was well-tolerated overall, with no significant hyperkalemia or hepatotoxicity reported in this group. These cases emphasize the real-world experience, promising efficacy and safety of Sparsentan in reducing proteinuria in patients with IgA-mediated glomerular disorders, including its application in combination therapies and patients with concurrent or prior immunosuppression.
Keywords: IgA nephropathy, sparsentan, IgA vasculitis, Proteinuria, Glomerulonephritis
Received: 26 Jul 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Sinha Roy, Errabelli, Lathiya and Mareedu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Neeharik Mareedu, neeharik.mareedu@gmail.com
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