Historia de la construcción II. 43 (2018) (Tercera Época) mayo-agosto. Boletín de Monumentos Históricos

- Editorial por Julieta García García.- Una pintura del mulato Tomás Sosa en España. San Antonio de Padua y el milagro de la mula: su hallazgo en una colección privada por Gabriela Sánchez Reyes, Andrés Santillán Medina y Guillermo Arce. - En busca de los enigmáticos vigilantes de la montaña y el sotavento: nuevos hallazgos, hipótesis y preguntas en torno del patrimonio fortificado de Veracurz por Sergio A. Vargas Matías. - Aproximación a un discurso gráfico en el antiguo convento agustino de Santa María Magdalena en Cuitzeo del Porvenir, municipio de Cuitzeo, Michoacán de Ocampo, México por María Lizbeth Aguilera GAribay.- Colegio de Nuestra Señora de Covadonga, Ciudad de México: siglos XVIII al XX. Historia de una institución escolar que quedó en intento por Alicia Bazarte Martínez, Leopoldo Rodríguez Morales y Alma Alicia Benítez Pérez.- El edificio de la Antigua Escuela Nacional de Agricultura y Veterinaria "San Jacinto": una historia a través de sus etapas constructivas por Yunien L. Maldonado Dorantes. - Pedro de Medina Picazo S.J., insigne benefactor por Verónica Zaragoza.- Etapas constructivas del templo de San Francisco Javier de Tepotzotlán (1670-1764) por Ricardo Uriel Peza Alvarado. - Posta de color y tiempo. La recuperación de la pintura mural exterior en el camarín de la Virgen de Loreto por Karina Xochipilli Rossell.- José Luis Curiel Monteagudo, La cocina en la ruta de las misiones de fray Junípero Serra, México, Porrúa, 2017 por Francisco Morales Valerio O.F.M.- Primer encuentro: Las revistas académicas del INAH. Balance y perspectivas, 13-17 de marzo de 2018 por María del Carmen León García

Sparsentan in patients with IgA nephropathy: a prespecified interim analysis from a randomised, double-blind, active-controlled clinical trial

Background: Sparsentan is a novel, non-immunosuppressive, single-molecule, dual endothelin and angiotensin receptor antagonist being examined in an ongoing phase 3 trial in adults with IgA nephropathy. We report the prespecified interim analysis of the primary proteinuria efficacy endpoint, and safety. Methods: PROTECT is an international, randomised, double-blind, active-controlled study, being conducted in 134 clinical practice sites in 18 countries. The study examines sparsentan versus irbesartan in adults (aged ≥18 years) with biopsy-proven IgA nephropathy and proteinuria of 1·0 g/day or higher despite maximised renin-angiotensin system inhibitor treatment for at least 12 weeks. Participants were randomly assigned in a 1:1 ratio to receive sparsentan 400 mg once daily or irbesartan 300 mg once daily, stratified by estimated glomerular filtration rate at screening (30 to 1·75 g/day). The primary efficacy endpoint was change from baseline to week 36 in urine protein-creatinine ratio based on a 24-h urine sample, assessed using mixed model repeated measures. Treatment-emergent adverse events (TEAEs) were safety endpoints. All endpoints were examined in all participants who received at least one dose of randomised treatment. The study is ongoing and is registered with ClinicalTrials.gov, NCT03762850. Findings: Between Dec 20, 2018, and May 26, 2021, 404 participants were randomly assigned to sparsentan (n=202) or irbesartan (n=202) and received treatment. At week 36, the geometric least squares mean percent change from baseline in urine protein-creatinine ratio was statistically significantly greater in the sparsentan group (-49·8%) than the irbesartan group (-15·1%), resulting in a between-group relative reduction of 41% (least squares mean ratio=0·59; 95% CI 0·51-0·69; p<0·0001). TEAEs with sparsentan were similar to irbesartan. There were no cases of severe oedema, heart failure, hepatotoxicity, or oedema-related discontinuations. Bodyweight changes from baseline were not different between the sparsentan and irbesartan groups. Interpretation: Once-daily treatment with sparsentan produced meaningful reduction in proteinuria compared with irbesartan in adults with IgA nephropathy. Safety of sparsentan was similar to irbesartan. Future analyses after completion of the 2-year double-blind period will show whether these beneficial effects translate into a long-term nephroprotective potential of sparsentan. Funding: Travere Therapeutics