Episodes
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In the latest episode of Kidney Compass: Navigating Clinical Trials, Hiddo Heerspink, PhD, PharmD, of the University of Groningen, joins the podcast after he presented the landmark SMART trial, which suggested the benefit of semaglutide (Ozempic/Wegovy) on chronic kidney disease (CKD) extend to patients without diabetes.
Video Version
During the episode, Heerspink shares the impetus behind the SMART study, explaining how early pandemic lockdowns offered time to explore semaglutide's application for CKD without diabetes. The group delves into the study's design, patient profile, and a 52% reduction in albuminuria observed with semaglutide. They address dose-dependency, how higher doses may amplify albuminuria reduction, and the relationship between creatinine and cystatin C as filtration markers.
The conversation shifts to broader implications, including the drug’s anti-inflammatory benefits, its potential for longer-term GFR protection, and specific impacts on blood pressure and BNP levels. As Heerspink elaborates, these results underscore semaglutide’s versatility, suggesting new therapeutic avenues across kidney and cardiovascular care. The episode concludes with a look at future research needs, including additional trials to clarify semaglutide’s role in non-diabetic CKD and broader nephrology applications.
Chapters
00:00 - Start
01:45 - SMART Trial Background
04:30 - Study Population Characteristics
06:10 - SMART Trial Results
07:35 - Dose-Dependent Effects of Semaglutide
09:15 - Filtration Markers
14:15 - Hypertension and BNP
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Relevant disclosures for Heerspink include AstraZeneca, Bayer AG, Boehringer Ingelheim Pharmaceuticals, Inc., Chinook Therapeutics Inc., Gilead Sciences, Inc., Eli Lilly and Company, Merck & Co., Inc., Novartis AG, Novo Nordisk A/S, Travere Therapeutics, and others. Relevant disclosures for Neuen include AstraZeneca, Bayer, Boehringer and Ingelheim, Janssen, and others. Relevant disclosures for Wadhwani include the National Institute of Diabetes and Digestive and Kidney Diseases, GSK, Calliditas and Travere Therapeutics. -
In the third and final on-site edition of Kidney Compass: Navigating Clinical Trials from the American Society of Nephrology’s Kidney Week 2024, Katherine Tuttle, MD, clinical professor of Medicine at University of Washington Medicine and executive director for Research at Providence Health Care, joins the program for a deep dive into new FLOW trial data at the meeting, the role of semaglutide (Ozempic) and GLP-1 receptor agonists in managing kidney disease, and prescribing responsibilities for new therapies with cardio-kidney-metabolic benefits.
To begin the episode, hosts Brendon Neuen, MBBS, PhD, and Shikha Wadhwani, MD, MS, ask Tuttle to review findings from the FLOW trial, particularly the effects of semaglutide on kidney and cardiovascular outcomes. Tuttle details the groundbreaking findings, which concluded semaglutide not only lowers the risk of kidney failure and GFR decline in patients with type 2 diabetes but also significantly reduces cardiovascular events and overall mortality.
They go on to discuss FLOW’s hierarchy of tested outcomes, confirming its broad efficacy across various levels of kidney function and albuminuria, which they highlight should be a notable reassurance for patients with more advanced CKD stages. Tuttle emphasizes the consistency of benefits regardless of SGLT2 inhibitor usage, pointing to potential additive effects when combining these therapies. The group also addresses semaglutide’s surprising reduction in infection rates, including COVID-19, which may point to its immune-modulating effects.
Tuttle encourages nephrologists to take an active role in prescribing GLP-1 receptor agonists to enhance holistic, cross-specialty care for patients with CKD. The episode concludes with a call to action for nephrologists to adopt a comprehensive approach to cardiovascular risk management, integrating these new therapies as a primary tool in improving outcomes for patients with complex, interconnected health needs.
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Chapters
00:00 - Start
00:50 - FLOW Overview
05:50 - Safety Outcomes
11:30 - Deep Dive into Mortality Data
13:30 - Mechanism Behind Lower Infection Risk
15:30 - Future of Kidney Disease Research
17:30 - Nephrologists Responsibility to Prescribe GLP-1s
Relevant disclosures for Tuttle include Eli Lilly and Company, Boehringer Ingelheim, Astra Zeneca, Gilead, Goldfinch Bio, Novo Nordisk, Travere Therapeutics, and Bayer. Relevant disclosures for Neuen include AstraZeneca, Bayer, Boehringer and Ingelheim, Janssen, and others. Relevant disclosures for Wadhwani include the National Institute of Diabetes and Digestive and Kidney Diseases, GSK, Calliditas and Travere Therapeutics. -
Missing episodes?
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Live from Kidney Week 2024!
Hosts Neuen and Wadhwani are joined by Prof. Jonathan Barratt to discuss atacicept's 96-week data from ORIGIN OLE, which he presented as a late-breaker at the meeting.
Video Version Here
Results of the study indicate atacicept use was associated with sustained reductions across multiple endpoints of interest, including a 66% (SE, 2%) mean reduction in Gd-IgA1 levels, a reduction in percentage of patients with hematuria from baseline (percentage change, 75%; 95% CI, -87% to -59%), and a mean reduction in UPCR of 52% (SE, 5%). The mean eGFR annualized slope was just -0.6 (SE, 0.5) mL/min/1.73m2 per year.
As the discussion unfolds, Barratt explains atacicept’s unique approach of targeting disease-causing cytokines and highlights the drug’s practical benefit as a weekly self-administered injection, making it accessible for long-term patient use. The conversation wraps up with insights into the global impact of ongoing phase 3 trials, the sponsor’s commitment to extended access, and how these steps could redefine outcomes for patients with IgA nephropathy.
Chapters
00:00 – Start
01:30 – Understanding Atacicept and Its Mechanism
05:00 – Phase 2 Trial Results and Clinical Impact
10:00 – Advantages of At-Home Therapy and Patient Adherence
13:00 – Future of IgA Nephropathy Treatment and Phase 3 Trials
Relevant disclosures of interest for Barratt included Argenx, Calliditas Therapeutics, Chinook Therapeutics, Galapagos NV, GSK, Novartis, and Travere Therapeutics. Relevant disclosures for Neuen include AstraZeneca, Bayer, Boehringer and Ingelheim, Janssen, and others. Relevant disclosures for Wadhwani include the National Institute of Diabetes and Digestive and Kidney Diseases, GSK, Calliditas and Travere Therapeutics. -
Introducing Kidney Compass: Navigating Clinical Trials, your guide to the latest in clinical trials and relevant updates in the world of nephrology—created by Brendon Neuen, MBBS, PhD, and Shikha Wadhwani, MD, MS.
Hosted on HCPLive, Kidney Compass was created to make the changing landscape of nephrology and clinical trials within the specialty easier to understand and navigate, with insights from Neuen and Wadhwani, but also special guests, including some of the leading trialists in the space.
In the inaugural episode of Kidney Compass, the hosts introduce listeners to the podcast’s mission and themselves. After discussing the goals of the podcast, hosts offer the audience insight into their personal journeys in the field, explaining how the need for equitable care and access to innovative therapies for patients with kidney disease has shaped their work.
Wadhwani, the director of Clinical trials in the Division of Nephrology and the vice chair of Clinical Research in the Department of Medicine at the University of Texas Medical Branch, provides the audience with insight into her past experiences at Northwestern University, where she launched the institution’s glomerular disease program, but also into what inspired her to pursue a career in nephrology.
Later, Neuen, nephrologist and director of the Kidney Trials Unit at Royal North Shore Hospital and senior research fellow at The George Institute for Global Health, describes how his experience in the northern regions of Australia and providing care for Indigenous Australians fueled his desire to pursue an impactful career in public health, with nephrology as his chosen medium to effect this change.
Looking ahead, the hosts share their excitement about diving deeper into various aspects of nephrology research in future episodes, including multiple planned episodes at the upcoming American Society of Nephrology’s Kidney Week 2024.
Relevant disclosures for Neuen include AstraZeneca, Bayer, Boehringer and Ingelheim, Janssen, and others. Relevant disclosures for Wadhwani include the National Institute of Diabetes and Digestive and Kidney Diseases, GSK, Calliditas and Travere Therapeutics.
Key Timestamps
Episode Chapters
00:00 - Start
01:30 - Wadhwani Intro
03:05 - Neuen Intro
05:40 - Wadhwani's Professional Experience
08:05 - Purpose of Kidney Compass
