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Survey: Diabetic Nephropathy Considered Renal Disease With Greatest Unmet Need for New Treatments

Products in late-stage development most likely to be used for stage 3 CKD

Decision Resources Group, a health care research firm located in Burlington, Mass., finds that among all physician specialties, diabetic nephropathy (DN) is considered the renal disease with the greatest unmet need for new therapeutic options. Primary care physicians (PCPs) rated DN as having significantly more of an unmet need than they did in 2012.

The findings were based on an online survey of 150 physicians (51 nephrologists, 50 endocrinologists, and 49 PCPs) in the U.S.

According to the respondents, the four most important attributes when choosing an agent for DN are 1) efficacy in reducing proteinuria; 2) efficacy in delaying the onset of end-stage renal disease; 3) efficacy in establishing blood pressure control (for nephrologists); and 4) efficacy in reducing the risk of non-fatal cardiovascular events (for endocrinologists and PCPs). Other key attributes addressed in the report included the importance of a specific DN indication; dosage frequency and formulation; and efficacy in establishing glycemic control.

According to endocrinologists and PCPs, the likelihood that a DN patient under their care will also see a nephrologist increases as the stage of chronic kidney disease (CKD) progresses.

The use of pharmacotherapy for DN patients varied by the severity of disease (microalbuminuria versus macroalbuminuria), physician specialty, and CKD stage.

Six products in late-stage development — canagliflozin (Invokana, Janssen), atrasentan (AbbVie), pyridoxamine dihydrochloride (Pyridorin, NephroGenex), finerenone (Bayer), CCX-140 (ChemoCentryx), and CTP-499 (Concert Pharmaceuticals) — are most likely to be used by surveyed physicians in patients with stage 3 CKD, but there is a significant number of likely candidates in all CKD stages.

“The most common treatment changes reported include being more aggressive with DN treatment; earlier diagnosis/increased screening/earlier referral to a nephrologist; and no longer using ACE/ARB combinations,” said analyst Rob Dubman.

Source: BioTrends Research Group; November 3, 2014.

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