Trial reportJournal of the American Society of Nephrology : JASN2009
Avosentan reduces albumin excretion in diabetics with macroalbuminuria.
Trial report in Journal of the American Society of Nephrology : JASN, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 96 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
96 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Meta-Analysis of Randomized Controlled Trials Assessing the Efficacy and Safety of Endothelin Receptor Antagonists in CKD.Clinical journal of the American Society of Nephrology : CJASN · 2026Pooled it
- Association of oral endothelin receptor antagonists with risks of cardiovascular events and mortality: meta-analysis of randomized controlled trials.European journal of clinical pharmacology · 2017Pooled it
- Endothelin Receptor Antagonism Improves Lipid Profiles and Lowers PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9) in Patients With Chronic Kidney Disease.Hypertension (Dallas, Tex. : 1979) · 2019Trial
- Determining the optimal dose of atrasentan by evaluating the exposure-response relationships of albuminuria and bodyweight.Diabetes, obesity & metabolism · 2018Trial
- Prediction of the effect of atrasentan on renal and heart failure outcomes based on short-term changes in multiple risk markers.European journal of preventive cardiology · 2016Trial
- Predictors of Atrasentan-Associated Fluid Retention and Change in Albuminuria in Patients with Diabetic Nephropathy.Clinical journal of the American Society of Nephrology : CJASN · 2015Trial
- The endothelin antagonist atrasentan lowers residual albuminuria in patients with type 2 diabetic nephropathy.Journal of the American Society of Nephrology : JASN · 2014Trial
- Predictors of congestive heart failure after treatment with an endothelin receptor antagonist.Clinical journal of the American Society of Nephrology : CJASN · 2014Trial
- Addition of atrasentan to renin-angiotensin system blockade reduces albuminuria in diabetic nephropathy.Journal of the American Society of Nephrology : JASN · 2011Trial
- Avosentan for overt diabetic nephropathy.Journal of the American Society of Nephrology : JASN · 2010Trial
- Activation of the Endothelin System in Chronic Kidney Disease and Kidney Transplant Recipients-Implications for Disease Progression.International journal of molecular sciences · 2026Article
- Molecular mechanisms and novel therapeutic targets of diabetic kidney disease.Chinese medical journal · 2026Review
- Research trends and performance of endothelin A receptor antagonist in kidney care: a bibliometric analysis.Renal failure · 2025Article
- CKDs at the Crossroads: From Failures to Future Therapies.Kidney international reports · 2025Review
- Endothelin receptor antagonists in chronic kidney disease.Nature reviews. Nephrology · 2025Review
- Selective endothelin A receptor antagonism in chronic kidney disease: improving clinical application.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Review
- Opportunities and challenges in the treatment of IgA nephropathy.Frontiers in pharmacology · 2025Review
- Potential New Treatments for Chronic Kidney Diseases: A Concise Review.Current pharmaceutical design · 2025Review
- Proteinuria and Progression of Renal Damage: The Main Pathogenetic Mechanisms and Pharmacological Approach.Medicina (Kaunas, Lithuania) · 2024Review
- Endothelin Inhibitors in Chronic Kidney Disease: New Treatment Prospects.Journal of clinical medicine · 2024Review
36 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite the first-line use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), there is still a large need to improve the prevention and progression of diabetic nephropathy and its associated cardiovascular events. Endothelin antagonists have shown anti-inflammatory, antifibrotic, and antiproteinuric effects in experimental studies. This study was a randomized, placebo-controlled, double-blind, parallel-design, dosage-range study of the effect of the endothelin-A antagonist avosentan (SPP301) on urinary albumin excretion rate (UAER) in patients with diabetic nephropathy. We randomly assigned 286 patients with diabetic nephropathy, macroalbuminuria (UAER 0.2 to 5.6 mg/min), and BP <180/110 mmHg to 12 wk of avosentan (5, 10, 25, and 50 mg) or placebo, in addition to standard ACEI/ARB therapy. Relative to baseline, all avosentan dosages decreased mean relative UAER (-16.3 to -29.9%) compared with placebo (35.5%). Median relative UAER decreased with all avosentan dosages (-28.7 to -44.8%) compared with placebo (12.1%). Creatinine clearance and BP were unchanged at 12 wk. The main adverse events were peripheral edema (12%), mainly with high (>/=25 mg) dosages of avosentan; significant increases in liver enzymes did not occur. Twenty-one (7.3%) patients experienced adverse events that led to withdrawal from study medication. In summary, the endothelin-A antagonist avosentan given in addition to standard ACEI/ARB treatment decreases UAER in patients with diabetic nephropathy and macroalbuminuria.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.