Diabetic nephropathy (DN), also referred to as diabetic kidney disease, is a common complication of diabetes. The current standard of care fails to halt the frequent progression of DN to kidney disease and, ultimately, kidney failure—a condition associated with severe morbidity / mortality and high costs to patients and payers. As a result, key opinion leaders (KOLs) indicate that efficacious therapies for DN are a major unmet need. KOLs weigh in on the anticipated nephroprotective effects that endothelin receptor antagonists, mineralocorticoid receptor antagonists, and SGLT-2 inhibitors may offer. These therapies represent the first potentially disease-modifying therapies, should they prove efficacious and safe. The increasing prevalence of DN, exacerbated by the dynamics between clinicians seeking to prescribe new, premium-priced therapies and payers seeking to control costs among an already expensive population, will help shape the changing DN market over the next ten years.
- Will the inclusion of cardiovascular endpoints in the clinical trials for select therapies be a competitive advantage once commercially available?
- How do KOLs view the different mechanisms of action of the therapies in early- and late-phase clinical development?
- What are the key remaining unmet needs in DN? Which drugs in development will fulfill these unmet needs?
- What market access and reimbursement challenges will the emerging therapies face in the G7? How will these challenges influence their uptake?
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