Indication

Primary IgA nephropathy

RAG rating

Red

Document type

Decision document

Place

Hertfordshire and West Essex ICB

Output type

Pharmacy / Prescribing

Sparsentan

 

Sparsentan (Filspari)

   HERTFORDSHIRE AND WEST ESSEX AREA PRESCRIBING COMMITTEE (HWE APC)

                           Sparsentan for treating primary IgA nephropathy

                                                                 RED

                      Recommended for restricted prescribing by specialist only.

                                    Not recommended for primary care prescribing.

Name generic (trade) Sparsentan (Filspari®)

What it is Dual endothelin angiotensin receptor antagonist

Indication The treatment of adults with primary immunoglobulin A nephropathy (IgAN) with a urine protein excretion ≥ 1.0 g/day (or urine protein-to-creatinine ratio ≥ 85mg/mmol)

Date decision last revised October 2025

Decision status Final

NICE / SMC Guidance NICE TA 1074 recommended for restricted use

HWE APC recommendation:

Sparsentan is recommended as an option for treating primary immunoglobulin A nephropathy in line with the recommendations stated by NICE TA 1074.

As detailed by NICE - in line with the summary of product characteristics only people with CKD stages 1 to 3 would be eligible for initiation with sparsentan (treatment can continue if people progress to CKD stage 4).

Sparsentan should be stopped after 36 weeks if a person's UPCR is 199mg/mmol or more and has not reduced by 20% or more since starting sparsentan.

National tariff excluded.

RED STATUS:

NOT RECOMMENDED FOR PRIMARY CARE PRESCRIBING.

RECOMMENDED FOR RESTRICTED PRESCRIBING BY SPECIALISTS

NICE TA 1074 recommendations:

Sparsentan can be used as option to treat primary immunoglobulin A nephropathy (IgAN) in adults with a:

• urine protein-to-creatinine ratio (UPCR) of 85mg/mmol or more, or
• urine protein excretion of 1.0 g/day or more
  
  It can only be used if the company provides it according to the commercial arrangement.

Sparsentan should be stopped after 36 weeks if a person's UPCR:

• is 199mg/mmol or more and
• has not reduced by 20% or more since starting sparsentan.

These recommendations are not intended to affect treatment with sparsentan that was started in the NHS before this guidance was published. People having treatment outside these recommendations may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop.

Review date: The recommendation is based upon the evidence available at the time of publication. This recommendation will be reviewed upon request in the light of new evidence becoming available.