IgA nephropathy (IgAN) is the leading cause of primary glomerulonephritis and has limited treatment options. Endothelin A (ETA) receptor activation drives increase in proteinuria, kidney inflammation and fibrosis. In interim results of a phase 2, open-label study in patients with IgAN (AFFINITY), atrasentan, a potent and selective ETA antagonist, was well tolerated and resulted in clinically meaningful proteinuria reduction. Meanwhile, in a post-hoc analysis in patients with type 2 diabetes and CKD (SONAR), treatment with sodium glucose cotransporter-2 inhibitors (SGLT2i) and atrasentan resulted in greater reductions in albuminuria compared to atrasentan alone (n=14).
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Noronha et al. (2024) studied this question.
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