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Welcome to #TenTweetNephJC
✳️10 tweets #NephJC catch-up ✳️
In the last NephJC, we discussed interim results📊from the PROTECT trial on efficacy & safety of Sparsentan in IgAN.
New light✨on the horizon for IgAN yet?
Check out this flying summary in case you've missed the chat!
✳️10 tweets #NephJC catch-up ✳️
In the last NephJC, we discussed interim results📊from the PROTECT trial on efficacy & safety of Sparsentan in IgAN.
New light✨on the horizon for IgAN yet?
Check out this flying summary in case you've missed the chat!
2/10
What did I miss?
3 decades of fateful trials of ERAs in PAH, HTN, DKD, FSGS & IgAN (AFFINITY,ALIGN) set the stage for
🛡️PROTECT🛡️
Sparsentan🎲Irbesartan
thelancet.com/journals/lance…
✔️Phase3⃣RCT
✔️Active-controlled
✔️Double-blind🚫
✔️18 countries🗺️
✔️134 sites🏥
The cohort⬇️
What did I miss?
3 decades of fateful trials of ERAs in PAH, HTN, DKD, FSGS & IgAN (AFFINITY,ALIGN) set the stage for
🛡️PROTECT🛡️
Sparsentan🎲Irbesartan
thelancet.com/journals/lance…
✔️Phase3⃣RCT
✔️Active-controlled
✔️Double-blind🚫
✔️18 countries🗺️
✔️134 sites🏥
The cohort⬇️
3/10
1 tweet methods
n=406
270 weeks (114+156 weeks open label with SGLT2i!)
➡️Carefully selected population for nil significant cardio/cerebro-vascular or hepatic disease
➡️On MLD/50% MLD of RAASi
➡️1:1 randomisation
➡️Stratification as per eGFR & proteinuria
➡️MMRM statistics
1 tweet methods
n=406
270 weeks (114+156 weeks open label with SGLT2i!)
➡️Carefully selected population for nil significant cardio/cerebro-vascular or hepatic disease
➡️On MLD/50% MLD of RAASi
➡️1:1 randomisation
➡️Stratification as per eGFR & proteinuria
➡️MMRM statistics
4/10
1 tweet results
After 36 weeks of Sparsentan👇
✅41% relative reduction in UPCR
✅Lesser number reached 40% reduction of eGFR, kidney failure or all-cause mortality📊
⏫Freq adverse effects in both groups! (88% vs 78%)
🟰 Similar body weight changes/use of diuretics/BP
1 tweet results
After 36 weeks of Sparsentan👇
✅41% relative reduction in UPCR
✅Lesser number reached 40% reduction of eGFR, kidney failure or all-cause mortality📊
⏫Freq adverse effects in both groups! (88% vs 78%)
🟰 Similar body weight changes/use of diuretics/BP
5/10
A figure paints 1000 words
🔣Geometric least square mean ratio between groups was 0.59 (CI 0.51-0.69)
🛡️Maximal slope of reduction of proteinuria achieved at week 4, continued to accrue up to week 36
Additionally, proteinuria reduction was similar across all sub-groups!
A figure paints 1000 words
🔣Geometric least square mean ratio between groups was 0.59 (CI 0.51-0.69)
🛡️Maximal slope of reduction of proteinuria achieved at week 4, continued to accrue up to week 36
Additionally, proteinuria reduction was similar across all sub-groups!
6/10
Give me something clever to say
Burning questions defying IgAN trials
🔥A different disease in different ethnicities,fiery variants in some?
🔥Different natural history in primary vs secondary?
🔥Native vs post-transplant?
🔥In children?
🔥With vasculitis?
@CaptainKidney79
Give me something clever to say
Burning questions defying IgAN trials
🔥A different disease in different ethnicities,fiery variants in some?
🔥Different natural history in primary vs secondary?
🔥Native vs post-transplant?
🔥In children?
🔥With vasculitis?
@CaptainKidney79
7/10
Chat consensus?
Very adequately put by @hswapnil
We need more data & accelerated approvals using surrogate end-points may not be a bad thing at all.
& Ahem, after rigorous trials & rounds of approval, there's the formidable next challenge- COST!💰
Chat consensus?
Very adequately put by @hswapnil
We need more data & accelerated approvals using surrogate end-points may not be a bad thing at all.
& Ahem, after rigorous trials & rounds of approval, there's the formidable next challenge- COST!💰
https://twitter.com/hswapnil/status/1661188894526717952?s=20
8/10
Quote (Question) of the fortnight (decade really)
Will we ever have an answer? Unless we look systematically at the natural course/course on non-immunosuppressive or immunosuppressive therapy by doing serial biopsies?
Quote (Question) of the fortnight (decade really)
Will we ever have an answer? Unless we look systematically at the natural course/course on non-immunosuppressive or immunosuppressive therapy by doing serial biopsies?
9/10
I want more info
Lots of information to check out!
🪶#NephJC summary by @Ren_Familia & @nephvishnoi
🎨Visual Abstract below by @nephvishnoi
Excellent,exhaustive tweetorials covering the topic👇🏻
🧵 @didemturgut_
🧵 @HecmagsMD
I want more info
Lots of information to check out!
🪶#NephJC summary by @Ren_Familia & @nephvishnoi
🎨Visual Abstract below by @nephvishnoi
Excellent,exhaustive tweetorials covering the topic👇🏻
🧵 @didemturgut_
https://twitter.com/ckd_ce/status/1521464649069301760?s=20
🧵 @HecmagsMD
https://twitter.com/ckd_ce/status/1508757986868559875?s=20
10/10
Final thoughts
Sparsentan (FILSPARI) holds promise.
➡️Convincing biological plausibility
➡️Favourable reduction in proteinuria
➡️Early onset effect
➡️Comparable side-effect profile
➡️Safety in study group (though carefully selected)
"Hope is a good thing, maybe the best!"
Final thoughts
Sparsentan (FILSPARI) holds promise.
➡️Convincing biological plausibility
➡️Favourable reduction in proteinuria
➡️Early onset effect
➡️Comparable side-effect profile
➡️Safety in study group (though carefully selected)
"Hope is a good thing, maybe the best!"
➡️Up next!🥁
'Sodium bicarbonate for kidney transplant recipients with metabolic acidosis in Switzerland🇨🇭'
thelancet.com/journals/lance…
Hope you enjoyed the first chat already! Gear up for the Asian chat coming up soon @ 9pm IST.
NSMC never sleeps!👇
Tweetorial by @SayaliBThakare
'Sodium bicarbonate for kidney transplant recipients with metabolic acidosis in Switzerland🇨🇭'
thelancet.com/journals/lance…
Hope you enjoyed the first chat already! Gear up for the Asian chat coming up soon @ 9pm IST.
NSMC never sleeps!👇
Tweetorial by @SayaliBThakare
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