Sparsentan (SPAR) is a novel, nonimmunosuppressive, single-molecule, dual endothelin angiotensin receptor antagonist (DEARA). In the ongoing PROTECT trial SPAR is compared to irbesartan in patients with IgAN. SGLT2is may slow disease progression in IgAN as suggested in subgroup analyses from DAPA-CKD and EMPA-KIDNEY. Combined DEARA and SGLT2i therapy may provide additional kidney-protective effects with unknown adverse events. Concomitant treatment with an SGLT2i was prohibited during the PROTECT double-blind (DB) period; however, SGLT2is are allowed in the PROTECT OLE.
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Komers et al. (2024) studied this question.
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