Summary

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• This summary is based on the review of one systematic review/meta-analysis. ^[1]
• Vanrafia (atrasentan) is indicated to reduce proteinuria in adults with primary immunoglobulin A nephropathy (IgAN) at risk of rapid disease progression, generally a urine protein-to-creatinine ratio (UPCR) ≥ 1.5 g/g.
• In 1346 patients with IgAN, endothelin A receptor antagonists (EARAs) reduced UPCR by a mean difference (MD) of -31.89 (95% CI -37.50 to -26.28).
• EARAs reduced systolic blood pressure by MD -2.78 (95% CI -4.11 to -1.44) and diastolic blood pressure by MD -4.12 (95% CI -5.24 to -2.99) in IgAN patients.
• Decline in estimated glomerular filtration rate (eGFR) was smaller in the EARA group, with a MD of 4.10 (95% CI -0.76 to 8.96).
• In IgAN patients, EARAs were associated with increased risks of anemia (OR 2.38, 95% CI 1.54 to 3.69), cough (OR 2.27, 95% CI 1.24 to 4.15), dizziness (OR 2.37, 95% CI 1.51 to 3.71), hypotension (OR 2.39, 95% CI 1.56 to 3.67), fluid retention (OR 1.46, 95% CI 1.04 to 2.05), and acute kidney injury (OR 3.12, 95% CI 1.31 to 7.42).
• There is no population types or subgroups information available in the reviewed studies.