According to the U.S. Centre for Disease Control and Prevention, around 37 million people suffer from chronic kidney disease, but due to the difficulty in obtaining a diagnosis for the condition, they remain unaware of the affliction.
Over a year ago, when AstraZeneca was able to bag FDA’s approval for its Farixga drug, it dominated the market for chronic kidney disease treatment. The drug acted as an SGLT2 inhibitor which prevented the kidney from reabsorbing blood sugar that was typically excreted through urine.
In 2020, the drug also gained landmark FDA approval for heart failure treatment and this label expansion has significantly contributed to sales that rose a billion dollars from 2020-2021 to $3 billion. This was a 53% increase in sales from the year prior. During the first half of 2022, AstraZeneca reported $2.1 billion in sales.
Farixga however, has a new rival in the market in the form of Lily and Boehringer’s Jardiance. The data that Lily and Boehringer have shared from their massive 6,609 participant trail has revealed that the pills were successful in reaching their primary endpoint or reducing kidney disease progression or cardiovascular death by 28% compared to the placebo in the trial. Another key secondary endpoint success for the pills was its ability to reduce hospitalization for any case by 14%.
The results of the trial were revealed during the American Society of Nephrology’s (ASN) Kidney Week, where investigators also shared the failure of the drug to meet other secondary endpoints such as cardiovascular death and hospitalization for heart failure. The company clarified that the number of events made it difficult for them to detect these things.
Like Farxiga, Jardiance is also an SGLT2 inhibitor, however unlike previous trials that only included certain groups of patients like those excreting high levels of proteins and had diabetes, the trial for Jardiance included a broad range of CKD patients such as those who had not yet started shedding the blood protein albumin through urine and still proved to be effective across the board.
The drug was exhibited in a 2020 trial called the DAPA-CKD and proved effective in cutting the risk of kidney disease progression, or death from kidney or cardiovascular causes by 39%.
The head of cardiovascular and metabolic medicine at Boehringer Ingelheim, Waheed Jamal said, “DAPA-CKD essentially enrolled a higher-risk population. We’ve enrolled a much broader population that is more representative of what you see in clinical practice.”
While the drug was initially only targeted toward diabetes patients, it has also been tested to prove beneficial for patients suffering from heart failure. It is possible that the drug may successfully slow the onset of complete loss of kidney function. This would in turn save patients from resorting to burdensome and costly treatments such as dialysis.
Only last year, Boehringer recorded about $3.84 billion in global Jardiance sales and lily received loyalty payments of up to $1.5 billion on it. Given recent developments, the companies are looking for extended authorization for CKD with global regulators.
