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The following is a summary of “Safety and efficacy of sparsentan versus irbesartan in focal segmental glomerulosclerosis and IgA nephropathy: a systematic review and meta-analysis of randomized controlled trials,” published in the September 2024 issue of Nephrology by Elnaga et al.
Sparsentan shows promise in managing glomerulonephritis. A pooled analysis is needed to validate recent trial results.
Researchers conducted a retrospective study to evaluate sparsentan’s safety and efficacy vs irbesartan in IgA nephropathy and focal glomerulosclerosis (FSGS).
They conducted a systematic review and meta-analysis of randomized controlled trials from various sources through March 2024 and used Review Manager v.5.4 to pool dichotomous data with risk ratio (RR) and continuous data with mean difference (MD) and 95% CI.
The results showed that 3 studies with 884 patients demonstrated that sparsentan was superior to irbesartan in improving the urine protein to creatinine ratio (UP/C) (ratio of percentage reduction 0.66, 95% CI [0.58 to 0.74], P<0.001) and in achieving complete (RR = 2.57, 95% CI [1.73 to 3.81], P<0.001) and partial remission of proteinuria (RR = 1.63, 95% CI [1.4 to 1.91], P<0.001). However, neither treatment significantly favored glomerular filtration rate (MD = 1.98 ml/min per 1.73mm2, 95% CI [-1.05 to 5.01], P=0.2), and while adverse events were similar, hypotension was more common in the sparsentan group (RR = 2.02, 95% CI [1.3 to 3.16], P=0.002).
The study concluded that sparsentan was effective and had a favorable safety profile for treating FSGS and IgA nephropathy. They noted that larger, well-designed RCTs comparing sparsentan with ARBs, ACE inhibitors, and steroids were needed for conclusive evidence.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03713-9
