Whereas sparsentan blocks each ETA and AT1 receptors, atrasentan (Vanrafia) is a focused remedy that focuses solely on ETA receptors. In 2025, it obtained FDA approval to deal with IgAN.
How Atrasentan Works
By blocking ETA receptors, atrasentan helps lower stress on the kidneys, which may cut back irritation and decrease proteinuria with out suppressing your immune system, says Garimella.
In a examine, adults taking atrasentan had a 38 % discount in proteinuria after 36 weeks, in contrast with a 3 % discount in these taking a placebo (a capsule containing no remedy).
All examine contributors continued normal supportive care, corresponding to ACE inhibitors or ARBs, and a few additionally took SGLT2 inhibitors.
Atrasentan is a capsule taken as soon as a day by mouth. Though it helps decrease proteinuria, researchers are nonetheless figuring out whether or not it additionally slows lengthy‑time period lack of kidney operate.
Who Is Eligible for Atrasentan?
To be eligible for atrasentan, you have to be an grownup with major IgAN in danger for quicker illness development.
This sometimes means having proteinuria, measured as a urine protein-to-creatinine ratio (uPCR) of 1.5 grams per gram or greater, regardless of receiving supportive care.
UPCR is a spot take a look at that measures protein leakage within the urine. Your nephrologist will take into account your proteinuria, kidney operate, and general well being to see if this therapy is acceptable for you.
Atrasentan may be added to ACE inhibitors and ARBs, whether or not or not you’re additionally taking an SGLT2 inhibitor, says Garimella. It’s additionally an possibility if you wish to keep away from immunosuppressive drugs like steroids, or when you’ve had liver‑associated unwanted effects with sparsentan, he says.
Some drugs can intervene with how atrasentan works. These embody sure antibiotics and seizure drugs. Others, just like the antifungal drug ketoconazole, may cause greater quantities of the remedy to construct up in your physique.
Let your nephrologist find out about all drugs and dietary supplements you’re taking.
Atrasentan may cause severe hurt to a growing child, so it’s not beneficial when you’re pregnant or planning to turn out to be pregnant.
Individuals who can turn out to be pregnant ought to use efficient contraception whereas taking this remedy and for 2 weeks after stopping therapy.
Widespread Aspect Results
Widespread atrasentan unwanted effects embody the next:
- Swelling within the legs, ankles, or ft
- Anemia
- Fluid retention
- Elevated liver enzymes
