Study summary

An endothelin-blocking pill reduced urine protein by about a third

ALIGN trial (atrasentan) · 340 people, phase 3 · Published October 2024, New England Journal of Medicine; FDA accelerated approval 2025

36.1percentage-point greater drop in urine protein than placebo

What was tested

Atrasentan, a pill that blocks the endothelin A receptor to reduce kidney scarring and protein leakage, against placebo, added to standard blood-pressure medicines.

What they found

Urine protein fell 38.1% vs 3.1% with placebo (36.1 points more).
Fluid retention was slightly more common (11.2% vs 8.2%).

What it means

Adds a kidney-protecting pill that can be combined with immune-targeting drugs.

N Engl J Med, via PubMed ↗ ← Back to the outlook

Last reviewed 2026-11-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.