Abstract：
UNASSIGNED: IgA nephropathy is one of the most common forms of glomerular disease. Patients with persistent proteinuria are at increased risk of progression to kidney failure. There is a significant need for safe and effective therapies to lower proteinuria in these patients. Sparsentan is a non-immunosuppressive agent that acts as a dual angiotensin and endothelin receptor antagonist. It lowers proteinuria in experimental models of glomerular disease and in affected patients.
UNASSIGNED: This review covers the immunological and non-immunological actions of sparsentan in glomerular disease. It reviews the clinical trials that evaluated the impact of the drug in pediatric and adult patients with IgA nephropathy. It places the use of sparsentan in an overall treatment paradigm for the full spectrum of patients with IgA nephropathy including nonspecific renoprotective agents such as inhibitors of the renin-angiotensin-aldosterone axis and SGLT2 transporter and immunosuppressive drugs. The review represents a search of the current literature about the effect of the drug on normal physiology and the pathogenesis of IgA nephropathy.
UNASSIGNED: The safety, tolerability, and therapeutic efficacy of sparsentan have been demonstrated in long-term studies of patients with primary glomerular diseases extending over 5 years. The evidence in support of a beneficial treatment effect of sparsentan is stronger in IgAN than in FSGS. It is anticipated that sparsentan will supplant the use of ACEI or ARB as the first-line therapy to reduce proteinuria prior to the implementation of immunosuppressive agents in patients with IgA nephropathy. It may be combined with other renoprotective drugs like SGLT2 inhibitors. Practice guidelines are needed to promote safe and effective use of this new drug by nephrologists caring for patients with IgAN in all clinical settings.
UNASSIGNED: This review covers the immunological and non-immunological actions of sparsentan in glomerular disease. It reviews the clinical trials that evaluated the impact of the drug in pediatric and adult patients with IgA nephropathy. It places the use of sparsentan in an overall treatment paradigm for the full spectrum of patients with IgA nephropathy including nonspecific renoprotective agents such as inhibitors of the renin-angiotensin-aldosterone axis and SGLT2 transporter and immunosuppressive drugs. The review represents a search of the current literature about the effect of the drug on normal physiology and the pathogenesis of IgA nephropathy.
UNASSIGNED: The safety, tolerability, and therapeutic efficacy of sparsentan have been demonstrated in long-term studies of patients with primary glomerular diseases extending over 5 years. The evidence in support of a beneficial treatment effect of sparsentan is stronger in IgAN than in FSGS. It is anticipated that sparsentan will supplant the use of ACEI or ARB as the first-line therapy to reduce proteinuria prior to the implementation of immunosuppressive agents in patients with IgA nephropathy. It may be combined with other renoprotective drugs like SGLT2 inhibitors. Practice guidelines are needed to promote safe and effective use of this new drug by nephrologists caring for patients with IgAN in all clinical settings.
摘要：
■IgA肾病是最常见的肾小球疾病之一。患有持续性蛋白尿的患者进展为肾衰竭的风险增加。对于降低这些患者的蛋白尿的安全且有效的疗法存在显著需求。Sparsentan是一种非免疫抑制剂，可作为血管紧张素和内皮素双重受体拮抗剂。它可以降低肾小球疾病实验模型和受影响患者的蛋白尿。
■这篇综述涵盖了sparsentan在肾小球疾病中的免疫和非免疫作用。它回顾了评估该药物对儿童和成人IgA肾病患者影响的临床试验。它将sparsentan用于IgA肾病患者的全谱治疗，包括非特异性肾保护剂，例如肾素-血管紧张素-醛固酮轴抑制剂和SGLT2转运蛋白和免疫抑制药物的抑制剂。该综述是对当前有关该药物对正常生理和IgA肾病发病机理的影响的文献的搜索。
■安全，耐受性,sparsentan的治疗效果已在原发性肾小球疾病患者的长期研究中得到证实。支持sparsentan有益治疗效果的证据在IgAN中比在FSGS中更强。预计在IgA肾病患者中使用免疫抑制剂之前，sparsentan将取代ACEI或ARB作为减少蛋白尿的一线疗法。它可以与其他肾脏保护药物如SGLT2i联合使用。需要实践指南，以促进肾病学家在所有临床环境中照顾IgAN患者安全有效地使用这种新药。
■这篇综述涵盖了sparsentan在肾小球疾病中的免疫和非免疫作用。它回顾了评估该药物对儿童和成人IgA肾病患者影响的临床试验。它将sparsentan用于IgA肾病患者的全谱治疗，包括非特异性肾保护剂，例如肾素-血管紧张素-醛固酮轴抑制剂和SGLT2转运蛋白和免疫抑制药物的抑制剂。该综述是对当前有关该药物对正常生理和IgA肾病发病机理的影响的文献的搜索。
■安全，耐受性,sparsentan的治疗效果已在原发性肾小球疾病患者的长期研究中得到证实。支持sparsentan有益治疗效果的证据在IgAN中比在FSGS中更强。预计在IgA肾病患者中使用免疫抑制剂之前，sparsentan将取代ACEI或ARB作为减少蛋白尿的一线疗法。它可以与其他肾脏保护药物如SGLT2i联合使用。需要实践指南，以促进肾病学家在所有临床环境中照顾IgAN患者安全有效地使用这种新药。
