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New therapeutic agent for FSGS: dual - channel inhibition of

  DUET trial phase 2 study found that antihypertensive drugs Sparsentan can be targeted treatment of primary focal stage of glomerulonephritis (FSGS).

  Dr. Howard Trachtman of the University of New York at the American Kidney Association's American Kidney Week (ASN) news conference in 2016 said, "Primary focal stage glomerulonephritis is a rare disease characterized by proteinuria that accelerates Is the leading cause of end - stage renal disease, nephrotic syndrome, the main reason for the need for dialysis or kidney transplant treatment.

  "Because of the increasing prevalence of FSGS and the lack of drugs currently available to treat the disease, there is an urgent need to develop effective therapeutics," Howard Trachtman said.

  The study found that Sparsentan (while blocking angiotensin II and endothelin 1) to reduce the effect of proteinuria was significantly greater than irbesartan. This result is a significant advance in the field of FSGS therapy.

  DUET trial included a total of 109 patients aged 8-71 years of FSGS. Subjects were randomized to receive sparsentan 200 mg / day, 400 mg / day, 800 mg / day, or angiotensin II receptor antagonist irbesartan 300 mg / day.

  The primary endpoint was urinary protein creatinine ratio baseline change. Secondary end point for the first 8 weeks of treatment of urinary protein creatinine ratio decreased ≥ 40%, partial remission: urine protein creatinine ratio of the smallest 1.5 g / g

  Research result

  At week 8, the mean decrease in urinary protein creatinine ratio was significantly greater in the Sparsentan group than in the irbesartan group. The mean reduction in urinary protein creatinine ratio was also significantly greater in the Sparsentan 400 mg and 800 mg groups than in the irbesartan group (47.4% vs 19.0%; P = 0.011).

  The partial response rate was significantly greater in the Sparsentan group than in the irbesartan group. In Sparsentan group, complete remission (defined as urinary protein creatinine ratio ≥ 0.3 g / g) in 4 cases, irbesartan group complete remission 0.

  There was no significant difference in safety between Sparsentan and irbesartan. Overall, the safety and tolerability of Sparsentan is better.

  The researchers said, Sparsentan is expected to be approved by the FDA for the treatment of FSGS first treatment.

  Source: Dual-Pathway Inhibitor Targets Glomerular Disease. Medscape. November 28, 2016

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