Chronic kidney disease (CKD) refers to a set of heterogenous disorders that affect the structure and function of the kidneys. The CKD drug market comprises a wide variety of antihypertensive agents and SGLT-2 inhibitors, which are intended to delay the progression of kidney damage. RAAS inhibitors are the standard of care for CKD. In 2021, AstraZeneca’s Farxiga (dapagliflozin) became the first SGLT-2 inhibitor to demonstrate a renoprotective effect in a dedicated CKD outcomes trial and to receive formal approval from the FDA for the treatment of CKD irrespective of the presence or absence of diabetes. In 2022, Eli Lilly’s Jardiance (empagliflozin) demonstrated renoprotective benefits among CKD patients in the EMPA-KIDNEY trial; this SGLT-2 inhibitor is expected to receive a label expansion to CKD in 2023. Johnson & Johnson’s Invokana (canagliflozin) also demonstrated renoprotective benefits in diabetic patients with CKD in the CREDENCE trial. Thus, SGLT-2 inhibitors are set to play an increasingly important role in CKD treatment. In 2021, Bayer’s Kerendia (finerenone), a mineralocorticoid receptor antagonist, was approved for CKD after demonstrating renoprotective and cardioprotective benefits in type 2 diabetes patients with CKD in the FIDELIO-DKD and FIGARO-DKD trials. Supported by insights from thought leaders, we analyze the challenges associated with marketing drugs to treat an increasingly dynamic and complex disease.
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