Comparison of eGFR Slopes in IgA Nephropathy With Sparsentan, Irbesartan

Wu Gong and fellow researchers reported results of the PROTECT clinical trial in IgA nephropathy (IgAN) during the National Kidney Foundation Spring Clinical Meetings. The trial evaluated the long-term nephroprotective potential of sparsentan (SPAR) versus maximally titrated irbesartan (MT-IRB).

PROTECT compared 2-year estimated glomerular filtration rate (eGFR) total slopes between the SPAR and MT-IRB groups and standard of care (SoC) in the following populations with similar eligibility criteria: a real-world data setting (UK National Registry of Rare Kidney Diseases [RaDaR] patients with IgAN) and a comparable clinical trial population with physician-confirmed optimized SoC required prior to enrollment (NefIgArd).

The researchers performed unanchored, matching-adjusted, indirect comparisons with matching based upon published clinical characteristics using the method of moments. They weighted patients in both groups to match key baseline characteristics of the comparator populations. Then, they calculated 2-year eGFR total slopes using random coefficients models. They used two-tailed z tests with pooled standard errors for indirect comparison.

Patients in both the MT-IRB and SPAR PROTECT groups had a significantly slower decline in kidney function compared with patients receiving SoC in the real-world setting of RaDaR and the clinical trial setting of NefIgArd.

The results between clinical trials should be considered in the context of clinical practice.

Source: Gong W, Diva U, Bensink M, et al. Matching-adjusted indirect comparisons of eGFR slopes in the PROTECT study with UK RaDaR IgA nephropathy population and the control arm of NefIgArd. Presented at the National Kidney Foundation Spring Clinical Meetings 2024; May 14-18, 2024; Long Beach, California.