Efficacy and safety of ambrisentan in IgA nephropathy: real-world evidence
- 1Department of Nephrology, Qilu Hospital of Shandong University
- 2Department of Blood Purification, Qilu Hospital of Shandong University
- 3Department of Nephrology, Pingyuan County First People's Hospital
Abstract
Background: Ambrisentan, an endothelin receptor antagonist, reduces proteinuria; however, insufficient evidence is available to support its use in IgAN. The aim of this research is to investigate the efficacy and safety of ambrisentan in the treatment of IgAN nephropathy.
Methods: This retrospective cohort study was enrolled 102 IgAN patients, which was confirmed by renal biopsy from Qilu Hospital, Shandong University (January 2021 to March 2026). 68 patients received ACEI/ARB treatment, while 34 IgAN patients received treatment with ACEI/ARB plus ambrisentan (5mg/day). The primary endpoint of the study assessed the percentage changes in UPCR in IgAN patients receiving different treatment regimens. Secondary endpoints included the change in eGFR and the safety of ambrisentan.
Results: 102 IgAN patients were enrolled in the research. ACEI/ARB + ambrisentan group exhibited higher rates of UPCR reduction compared with ACEI/ARB group: -35.9% [IQR, -46.7%, -12.2%] vs -11.8.0% [IQR, -35%, 3.19%] (P = 0.004) at 1 month, -52% [IQR, -61.6%, -26.6%] vs -22.4% [IQR, -42.5%, -2.8%] (P = 0.001) at 3 months, -43.1% [IQR, -61.3%, -27%] vs -29.8% [IQR, -52%, -0.2%] (P = 0.015) at 6 months. Furthermore, the UPCR was lower in the ACEI/ARB + ambrisentan group (0.45 g/g [IQR, 0.25, 0.85] vs 0.86 g/g [IQR, 0.52, 1.15]; P = 0.006) at 3 months, and (0.50 g/g [IQR, 0.37, 0.69] vs 0.85g/g [IQR, 0.51, 1.14]; P = 0.003) at 6 months. However, no statistically significant difference was observed between the two groups in terms of serum albumin levels. After treatment, the percentage change in eGFR from baseline was higher in the combination therapy group than in the ACEI/ARB group (1.6% vs -1.6%, p=0.014). At 6 months, the response rate in the ACEI/ARB + ambrisentan group was significantly higher (70.59% vs 48.53%, P = 0.034). Both groups experienced no serious adverse reactions.
Conclusions: The addition of ambrisentan to renin-angiotensin-aldosterone system (RAS) blockers significantly reduces urinary protein in IgAN patients, while remaining relatively safe.
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BibTeX
@article{yu2026efficacy,
title = {{Efficacy and safety of ambrisentan in IgA nephropathy: real-world evidence}},
author = {Kuipeng Yu and Ke Zhao and Xingyu Chen and Fangli Wang and Sha Wang and Chunjie Wang and Fang Bai and Haiyun Li and Ling Guo and Xiangdong Yang},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1967776},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1967776/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Efficacy and safety of ambrisentan in IgA nephropathy: real-world evidence
AU - Kuipeng Yu
AU - Ke Zhao
AU - Xingyu Chen
AU - Fangli Wang
AU - Sha Wang
AU - Chunjie Wang
AU - Fang Bai
AU - Haiyun Li
AU - Ling Guo
AU - Xiangdong Yang
PY - 2026
DA - 2026/10/29
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1967776
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1967776/full
AB - Background: Ambrisentan, an endothelin receptor antagonist, reduces proteinuria; however, insufficient evidence is available to support its use in IgAN. The aim of this research is to investigate the efficacy and safety of ambrisentan in the treatment of IgAN nephropathy. Methods: This retrospective cohort study was enrolled 102 IgAN patients, which was confirmed by renal biopsy from Qilu Hospital, Shandong University (January 2021 to March 2026). 68 patients received ACEI/ARB treatment, while 34 IgAN patients received treatment with ACEI/ARB plus ambrisentan (5mg/day). The primary endpoint of the study assessed the percentage changes in UPCR in IgAN patients receiving different treatment regimens. Secondary endpoints included the change in eGFR and the safety of ambrisentan. Results: 102 IgAN patients were enrolled in the research. ACEI/ARB + ambrisentan group exhibited higher rates of UPCR reduction compared with ACEI/ARB group: -35.9% [IQR, -46.7%, -12.2%] vs -11.8.0% [IQR, -35%, 3.19%] (P = 0.004) at 1 month, -52% [IQR, -61.6%, -26.6%] vs -22.4% [IQR, -42.5%, -2.8%] (P = 0.001) at 3 months, -43.1% [IQR, -61.3%, -27%] vs -29.8% [IQR, -52%, -0.2%] (P = 0.015) at 6 months. Furthermore, the UPCR was lower in the ACEI/ARB + ambrisentan group (0.45 g/g [IQR, 0.25, 0.85] vs 0.86 g/g [IQR, 0.52, 1.15]; P = 0.006) at 3 months, and (0.50 g/g [IQR, 0.37, 0.69] vs 0.85g/g [IQR, 0.51, 1.14]; P = 0.003) at 6 months. However, no statistically significant difference was observed between the two groups in terms of serum albumin levels. After treatment, the percentage change in eGFR from baseline was higher in the combination therapy group than in the ACEI/ARB group (1.6% vs -1.6%, p=0.014). At 6 months, the response rate in the ACEI/ARB + ambrisentan group was significantly higher (70.59% vs 48.53%, P = 0.034). Both groups experienced no serious adverse reactions. Conclusions: The addition of ambrisentan to renin-angiotensin-aldosterone system (RAS) blockers significantly reduces urinary protein in IgAN patients, while remaining relatively safe.
SN - 1664-3224
ER -