Jennifer Lai Yee, MD, PhD, MPH: Honing in on Sparsentan’s Benefit in Genetic FSGS

Sparsentan was similarly effective in treating patients with genetic focal segmental glomerulosclerosis (FSGS) as it was in treating those with other forms of FSGS, according to a posthoc analysis of the largest clinical trial to date in FSGS.

An analysis of the DUPLEX trial, which was presented at the American Society of Nephrology’s Kidney Week 2024 by principal investigator Jennifer Lai Yee, MD, PhD, MPH, of the Department of Pediatrics in the Division of Nephrology at the University of Michigan, suggests that patients with gFSGS experienced a more pronounced antiproteinuric response with sparsentan compared with irbesartan for the duration of the study period.

“FSGS is heterogeneous and DUPLEX [includes patients] with overall FSGS with all kinds of different mechanisms. And I think our study focused on this subgroup that [historically], people think [will not] respond to any treatment, but our findings support that there's medication available and it can benefit their lives, definitely,” Yee told HCPLive.

In the post-hoc analysis, Yee and colleagues identified a total of 31 individuals identified as having gFSGS. Relative to the overall DUPLEX population, patients with gFSGS were younger and had a greater eGFR at baseline, with most having a nephrotic-range proteinuria.

Yee noted that complete remission was only achieved by 1 patient with gFSGS compared to 0 with irbesartan. Additionally, investigators highlighted 3 individuals reached end-stage kidney disease with irbesartan relative to 1 patient with sparsentan.

“For this group of patients with FSGS, there’s this unmet need to develop something that can make a meaningful difference. I think sparsentan is definitely the first step to move towards to that goal. And at least, right now, we have something sort of available,” Yee said.

REFERENCE

Lai Yee J, Gong W, Inrig JK, et al. Outcomes of the DUPLEX Trial in Patients with Genetic Focal Segmental Glomerulosclerosis (gFSGS). Presented at American Society of Nephrology Kidney Week 2024. San Diego, CA. October 23-27, 2024.