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Atrasentan in IgA nephropathy

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Endothelin-1 is a vasoactive peptide implicated in the pathophysiology of IgA nephropathy

  • binding of endothelin-1 to the endothelin type A receptor in the kidney causes endothelial and podocyte damage, mesangial expansion, and tubular inflammation in experimental models of IgA nephropathy

  • atrasentan, an endothelin receptor antagonist (ERA), decreased albuminuria and reduced the risk of kidney failure in the Study of Diabetic Nephropathy with Atrasentan (SONAR) trial (1)

  • in a prespecified interim analysis of the ALIGN trial, atrasentan resulted in a significant and clinically meaningful reduction in proteinuria as compared with placebo in patients with IgA nephropathy (2)

 

Reference:

  1. Heerspink HJL et al ; SONAR Committees and Investigators .Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): A double-blind, randomised, placebo-controlled trial. Lancet 393: 1937–1947, 2019
  2. Heerspink HJL et al; for the ALIGN Study Investigators. Atrasentan in Patients with IgA Nephropathy. NEJM October 25th 2024.

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