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ASN: Atrasentan Significantly and Clinically Meaningfully Cuts Proteinuria

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Findings seen in patients with IgA nephropathy, compared with placebo

By Lori Solomon HealthDay Reporter

WEDNESDAY, Oct. 30, 2024 (HealthDay News) — Atrasentan is associated with a significant and clinically meaningful reduction in proteinuria compared with placebo in patients with immunoglobulin A (IgA) nephropathy, according to a study published online Oct. 25 in the New England Journal of Medicine to coincide with Kidney Week, the annual meeting of the American Society of Nephrology, held from Oct. 23 to 27 in San Diego.

Hiddo J. L. Heerspink, Ph.D., from the University of Groningen in the Netherlands, and colleagues assessed the efficacy and safety of the selective endothelin type A receptor antagonist atrasentan in reducing proteinuria in patients with IgA nephropathy. The analysis included 270 patients randomly assigned to either atrasentan (0.75 mg per day) or placebo for 132 weeks.

The researchers found that the geometric mean percentage change in the urinary protein-to-creatinine ratio relative to baseline was significantly greater with atrasentan (−38.1 percent) than with placebo (−3.1 percent), with a geometric mean between-group difference of −36.1 percentage points. The percentage of patients with adverse events was similar between the two groups. Fluid retention occurred in 11.2 percent in the atrasentan group and in 8.2 percent in the placebo group but did not lead to discontinuation of the trial regimen. There were no cases of cardiac failure or severe edema reported.

“In this prespecified interim analysis, atrasentan resulted in a significant and clinically meaningful reduction in proteinuria as compared with placebo in patients with IgA nephropathy,” the authors write.

The study was funded by Novartis, the developer of atrasentan.

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