In the short term, the endothelin antagonist avosentan reduces proteinuria, but whether this
translates to protection from progressive loss of renal function is unknown. We examined the
effects of avosentan on progression of overt diabetic nephropathy in a multicenter,
multinational, double-blind, placebo-controlled trial. We randomly assigned 1392
participants with type 2 diabetes to oral avosentan (25 or 50 mg) or placebo in addition to
continued angiotensin-converting enzyme inhibition and/or angiotensin receptor blockade …