Lessons learned from early-stage clinical trials for diabetic nephropathy

INTRODUCTION: The evolution of treatment for diabetic nephropathy illustrates how basic biochemistry and physiology have led to new agents such as SGLT2 inhibitors and mineralocorticoid blockers. Conversely, clinical studies performed with these agents have suggested new concepts for investigational drug development. We reviewed currently available treatments for diabetic nephropathy and then analyzed early clinical trials of new agents to assess the potential for future treatment modalities.

AREAS COVERED: We searched ClinicalTrials.gov for new agents under study for diabetic nephropathy in the past decade. Once we have identified investigation trials of new agents, we then used search engines and Pubmed.gov to find publications providing insight on these drugs. Current treatments have shown benefit in both cardiac and renal disease. In our review, we found 51 trials and 43 pharmaceuticals in a number of drug classes: mineralocorticoid blockers, anti-inflammatory, anti-fibrosis, nitric oxide stimulatory, and podocyte protection, and endothelin inhibitors.

EXPERT OPINION: It is difficult to predict which early phase treatments will advance to confirmatory clinical trials. Current agents are thought to improve hemodynamic function. However, the coincident benefit of both myocardial function and the glomerulus argues for primary effects at the subcellular level, and we follow the evolution of agents which modify fundamental cellular processes.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:33

Enthalten in:

Expert opinion on investigational drugs - 33(2024), 4 vom: 11. Apr., Seite 287-301

Sprache:

Englisch

Beteiligte Personen:

Rendell, Marc [VerfasserIn]

Links:

Volltext

Themen:

Anti-Inflammatory Agents
Chronic kidney disease
Glomerular filtration rate
Journal Article
Mineralocorticoid receptor agonists
Mineralocorticoids
Nephropathy
Review
SGLT2 inhibitors
Sodium-Glucose Transporter 2 Inhibitors

Anmerkungen:

Date Completed 08.04.2024

Date Revised 08.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1080/13543784.2024.2326025

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369552008