In early 2023, the dual endothelin–angiotensin receptor antagonist sparsentan became the first non-immunosuppressive therapy to be approved by the US Food and Drug Administration for the treatment of IgA nephropathy (IgAN), on the basis of data that showed a reduction in proteinuria. Two new clinical trials presented at ASN Kidney Week 2023 further support the renoprotective potential of this therapy — not only in IgAN, but also in focal segmental glomerulosclerosis (FSGS).