Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by the development and progressive enlargement of fluid-filled cysts in the kidneys. Particularly in the early stages, the disease is often asymptomatic and detectable only through diagnostic imaging of the kidney to reveal cysts. Until recently, treatment has focused on reducing blood pressure and pain and managing infection. However, the U.S. launch of Otsuka’s Jynarque (tolvaptan) in 2018 introduced the first disease-specific therapy for ADPKD. This therapy is approved for the treatment of ADPKD patients at risk of rapidly progressing. We examine how Jynarque’s launch has impacted ADPKD patient treatment and the challenges / opportunities that emerging therapies will face entering this market.


  • How are patients diagnosed, categorized, and monitored? Is patient risk categorized? How frequently are patients monitored?
  •  Which patients are prescribed Jynarque? For which attributes do physicians think Jynarque performs best / worst? How has Jynarque’s launch affected the ADPKD treatment algorithm?
  • Which clinical endpoints and trial comparators resonate most with physicians?
  • Based on four hypothetical drug product profiles, which attributes are most important to physicians’ prescribing decisions?


  • Geography: United States
  • Primary research survey of 100 U.S. nephrologists
  • Key drugs / drug classes covered: Jynarque, ACE / ARBs, CCBs, aldosterone agonists
  • Key insights provided:
    • Analysis of drug development opportunities
    • Factors influencing disease management and treatment decisions
    • Drivers and constraints of treatment selection
    • Physician-reported treatment practices and brand-level patient shares
    • Rationale for changes in treatment approach
    • Physician-reported recent / anticipated changes in brand usage or treatment approach
    • Physician perceptions of unmet needs in the indication and related indications


Special Topics provides physician insights on treatment dynamics, prescribing behavior, and drivers of brand. It supports clinical development decisions by identifying key attributes and assessing areas of unmet need. Insights into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities are provided.

Table of contents

  • Polycystic Kidney Disease - Current Treatment - Special Topics - Polycystic Kidney Disease - US
    • Special Topics PKD US September 2019

Author(s): David Rees, Ph.D; Graeme Green, PhD, MSc

David Rees, M.Biochem., Ph.D, is a Business Insights Analyst with the Cardiovascular, Metabolic, and Renal Disorders team at Decision Resources Group. Prior to joining Decision Resources Group, Dr. Rees was a Postdoctoral Research Associate at Imperial College London, and the Institute of Cancer Research. For his doctoral research, he studied the structures of molecular machines in the Nobel Prize winning laboratory of Prof. Sir John Walker at the University of Cambridge. Dr. Rees earned his undergraduate M.Biochem. from the University of Bath.

Graeme Green, M.Sc., Ph.D., is a director of Decision Resources Group's Cardiovascular, Metabolic and Renal team, where he is focused on the group’s hematology and cardiovascular coverage. He also leads the team’s commercial and therapeutic landscape analysis.  Dr. Green joined DRG in 2007 as a cardiovascular analyst and has authored insight reports covering market dynamics and drug development.

Dr. Green holds a Ph.D. in molecular medical microbiology from King’s College London, he also holds an M.Sc. in forensic science and a B.Sc. in biomedical sciences, both also from King’s College. Prior to joining DRG Dr. Green worked for a financial management consultancy.