The FDA expanded Travere Therapeutics’ Filspari (sparsentan) label, making it the first US-approved therapy for focal segmental glomerulosclerosis (FSGS). The update builds on Filspari’s earlier indications in rare kidney disease, and marks a regulatory milestone for a patient population with few approved options. For clinicians, the immediate impact is clearer treatment positioning in FSGS—an area where therapeutic selection has historically been constrained by limited evidence and inconsistent response rates across patients. The change also increases pressure on competitors to demonstrate differentiated outcomes in proteinuric glomerular diseases as FSGS moves into a more defined US treatment pathway.