Long-Term Real-World Evidence of Sparsentan Efficacy in Patients with IgA Nephropathy Treated with SGLT2 Inhibitors

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ID: 315456
2026
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Abstract
Abstract Background Sparsentan has emerged as a promising therapeutic option for IgA nephropathy. However, data on its effectiveness in real-world settings, particularly in combination with SGLT2 inhibitors remain limited. In our previously published real-world cohort (n=23), we demonstrated a significant reduction in proteinuria with concurrent SGLT2 inhibitor treatment. Here, we present 1-year follow-up data. Methods After one year, 17 patients (74%) from the initial cohort remained on sparsentan therapy. As described previously, patients had been on stable, maximally tolerated RAS inhibition and stable SGLT2 inhibitor therapy before replacement of RAS inhibition with sparsentan; eligibility required an eGFR >30 ml/min/1.73 m2 and a urine protein-creatinine ratio (UPCR) >0.75 g/g. Results Baseline median (IQR) eGFR (CKD-EPI) was 48 mL/min/1.73 m2 (34-66) and median UPCR was 1.55 g/g (0.90-1.85). At 1-year follow-up, UPCR remained significantly reduced (p=0.0001) to a median of 0.54 g/g (0.34-0.76), corresponding to a relative reduction of 61 % (45-95). The median chronic eGFR-slope was -1.5 mL/min/1.73 m2 per year (-7.51 to +3.75) at follow-up. Conclusions In this 1-year follow-up of our real-world cohort, sparsentan was associated with a significant and sustained reduction in proteinuria over 12 months, with a numerically less steep eGFR decline during follow-up, even in patients already receiving SGLT2 inhibitors.
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Authors Moritz Schanz, Claudia Seikrit, Bernd Hohenstein, Aline Zimmermann, Leonie Kraft, Severin Schricker, A. Schwab, Tina Oberacker, Joerg Latus
Journal clinical kidney journal
Year 2026
DOI
10.1093/ckj/sfag181
URL
https://doi.org/10.1093/ckj/sfag181
Keywords Keywords not found

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