Sparsentan blocks each ETA and AT1 receptors, whereas atrasentan (Vanraffia) is a focused remedy that focuses solely on ETA receptors. In 2025, it obtained FDA approval for the therapy of IgAN.
How atrasentan works
By blocking ETA receptors, atrasentan can scale back stress on the kidneys, scale back irritation and scale back proteinuria with out suppressing the immune system, Garimella says.
In a single examine, adults who took atrasentan had a 38 p.c discount in proteinuria after 36 weeks, in contrast with a 3 p.c discount in adults who took a placebo (a capsule with out the drug). All examine members continued normal supportive care, together with ACE inhibitors and ARBs, and a few additionally took SGLT2 inhibitors.
Atrasentan is a pill that’s taken orally as soon as a day. It helps scale back proteinuria, however researchers are nonetheless figuring out whether or not it additionally slows long-term decline in kidney perform.
Who’s Atrasentan meant for?
To be eligible to obtain atrasentan, you have to be an grownup with major IgAN who’s in danger for sooner illness development. This normally means having proteinuria with a urine protein-to-creatinine ratio (uPCR) of 1.5 g/g or extra regardless of receiving supportive care. UPCR is a spot take a look at that measures protein leakage within the urine. Your nephrologist will contemplate your proteinuria, kidney perform, and total well being to find out whether or not this therapy is best for you.
Garimella says atrasentan could be added to ACE inhibitors or ARBs, no matter whether or not they’re additionally used with an SGLT2 inhibitor. It is also an possibility if you wish to keep away from utilizing immunosuppressants reminiscent of steroids, or when you’ve had liver-related unwanted effects with sparsentan, he says.
Some medicines can intervene with the results of atrasentan. These embody sure antibiotics and seizure drugs. Some medication, such because the antifungal drug ketoconazole, can accumulate giant quantities within the physique. Inform your nephrologist about all medicines and dietary supplements you’re taking.
Atrasentan may cause critical hurt to a growing child and isn’t really helpful if you’re pregnant or planning to develop into pregnant. Individuals who might develop into pregnant ought to use efficient contraception whereas taking this drug and for two weeks after stopping therapy.
widespread unwanted effects
Frequent unwanted effects of atrasentan embody:
- swelling of the legs, ankles, or ft
- anemia
- fluid retention
- Elevated liver enzymes
