Focal segmental glomerulosclerosis (FSGS) has long been treated with supportive care and off-label immunosuppression. In 2026, sparsentan became the first therapy with full FDA approval specifically for FSGS, a significant shift in how the disease can be managed.
Sparsentan is a single molecule that blocks both the endothelin type A receptor and the angiotensin II type 1 receptor, two pathways that drive glomerular injury and proteinuria. Its approval was supported by the DUPLEX and DUET trials, which showed meaningful reductions in proteinuria.
The approval is especially timely for our community: Dr. Gerald Appel of Columbia University will cover these advances in his upcoming Bayou City Bean Club talk, "The Progress in FSGS."