Importance of CV benefits will help spur SGLT-2 inhibitor uptake in diabetic nephropathy.
By Kevin Shannon, Analyst
18 May 2016
I am an analyst at Datamonitor Healthcare, currently located in San Diego, California, where I am a member of the cardio...
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A combination of cardiovascular and renal benefits, displayed by Jardiance and expected for Invokana, along with their benefits on glucose reduction, will allow SGLT-2 inhibitors to dominate in diabetic nephropathy with nearly half of the market, by revenue, in 2025. The cardiovascular (CV) benefits have proven particularly important to patients and physicians:
“What I’ve learned in my career is if there’s a drug that reduces mortality and it’s neutral on the kidney, people are going to love it. If there’s a drug that slows progression of nephropathy but is neutral in cardiovascular events, they’re going to be skeptical about it: ‘Well that’s nice but what happened to cardiovascular events?’ The kidney’s always a second class citizen here.”
– US key opinion leader
Both diabetes and chronic kidney disease impart a high risk of CV disease, which is even greater than the risk of renal progression in various segments. The risk is worse as albuminuria increases and glomerular filtration rate declines. Phase III trials for Jardiance revealed it reduces the risk heart failure hospitalization and cardiovascular death consistently in patients with type 2 diabetes. After a number of trials failed to show a CV benefit from intensive glucose control with other agents, Jardiance’s success in its CVOT was impressive, though the mechanism may involve its diuretic effect. The reduction in events extended beyond those with known heart failure, and there are hypothesis on which patients benefit most. Further trials coming to completion in 2017 are expected to demonstrate this is an SGLT-2 inhibitor class benefit.
|Figure: Diabetic nephropathy sales of specific drug franchises across the US, Japan, and five major EU markets, 2025|
|Source: Datamonitor Healthcare|
Datamonitor Healthcare’s Diabetic Nephropathy: Forecast reveals the expected impact of recent cardiovascular data on revenue generated by pipeline drugs expected to launch in diabetic nephropathy.
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