The Evolving IgAN Treatment Landscape and Advances in FSGS, with Sayna Norouzi, MD

For many years, patients with IgA nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS) and their nephrologists have faced a frustrating reality: the absence of FDA-approved therapies. Instead, treatment largely relied on supportive measures, non-specific immunosuppression, and off-label approaches, with limited ability to alter the long-term risk of kidney failure.

Now, the landscape is beginning to shift, with recent FDA approvals and promising developments ushering in a new era of hope for patients and providers managing these glomerular diseases.

In an interview with HCPLive, Sayna Norouzi, MD, an assistant professor of medicine, clinical nephrologist, and founder and director of the glomerular disease and polycystic kidney disease clinics at Loma Linda University Medical Center, explains how for many years, providers were diagnosing patients with IgAN but had limited options to offer them in the way of treatment.

“We never had an FDA-approved medication out there to say ‘Hey, let's sit down and let's talk about your options,’ or to talk with patients about what medications we could start them on today that could hopefully prevent dialysis in the future,” Norouzi said. “Then, all of a sudden, we started receiving a lot of good news about the IgA nephropathy landscape.”

Specifically, she cites the FDA approvals of delayed budesonide (Tarpeyo), sparsentan (Filspari), and iptacopan (Fabhalta), describing the impact the availability of these medications has had on patient care and the emergence of conversations about combination therapy in light of now having multiple treatment options to offer patients. Additionally, she points to the need for further research on the long-term impacts of these medications.

Although FSGS does not yet have any FDA-approved therapies, Norouzi expresses optimism that one might be on the way following Travere Therapeutics’ submission of a supplemental New Drug Application for sparsentan.1

“I think every nephrologist out there can agree with me that sometimes, at some point with treatment of FSGS, we aren’t sure what else we can do,” Norouzi explained.” We are trying different medications and they are not responding, and you see that they still have protein in the urine, and as long as you have protein in the urine, you're going to be at risk of losing your kidney function and ending up on dialysis at some point.”

She goes on to describe how the prospect of having an FDA-approved treatment to offer patients with FSGS brings her a lot of hope.

“It's such an exciting time to be a nephrologist and to be an expert on glomerular disease,” Norouzi said. “Hearing about the newly FDA-approved medications, all the clinical trials that are ongoing, and possibilities for the future and for my patients, it makes my job more interesting these days and I feel like I'm happier as a nephrologist because we have more options.”

Editors’ note: Norouzi has relevant disclosures with Calliditas, Novartis, Otsuka, and Boehringer Ingelheim.

Reference

Brooks A. Travere Therapeutics Submits sNDA for Sparsentan (Filspari) in FSGS. HCPLive. March 17, 2025. Accessed April 28, 2025. https://www.hcplive.com/view/travere-therapeutics-submits-snda-sparsentan-filspari-fsgs