Long-term real-world evidence of sparsentan efficacy in patients with IgA nephropathy treated with SGLT2 inhibitors.

Authors

Moritz Schanz, Claudia Seikrit, Bernd Hohenstein, Aline Zimmermann, Leonie Kraft, Severin Schricker, Andrea Schwab, Tina Oberacker, Joerg Latus

Published in

Clinical kidney journal. Volume 19. Issue 7. Pages sfag181. Epub Jun 01, 2026.

Abstract

Sparsentan has emerged as a promising therapeutic option for immunoglobulin A nephropathy. However, data on its effectiveness in real-world settings, particularly in combination with sodium-glucose cotransporter 2 (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.
After 1 year, 17 patients (74%) from the initial cohort remained on sparsentan therapy. As described previously, patients had been on stable, maximally tolerated renin-angiotensin system (RAS) inhibition and stable SGLT2 inhibitor therapy before replacement of RAS inhibition with sparsentan; eligibility required an estimated glomerular filtration rate (eGFR) >30 ml/min/1.73 m² and a urine protein/creatinine ratio (UPCR) >0.75 g/g.
Baseline median (interquartile range) eGFR (Chronic Kidney Disease Epidemiology Collaboration) 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 = .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.
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.

PMID:
42422566
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.

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