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SGLT2 Inhibitors Poised to Potentially Reshape Chronic Kidney Disease (CKD) and Diabetic Kidney Disease (DKD) Patient Care After AstraZeneca’s Farxiga Approval

According to new research from Spherix Global Insights, the FDA approval of Farxiga is likely to ignite a shift towards earlier CKD patient care with agents in the SGLT2 inhibitor class, including Invokana (Vifor/Janssen), Jardiance (Eli Lilly/Boehringer Ingelheim), and Steglatro (Merck)

EXTON, Pa., / May 12, 2021 / PRNewswire – Nephrologists have long considered chronic kidney disease (CKD) progression and diabetic kidney disease (DKD) as areas in dire need of new and better therapeutic options for treatment. Data over the past few years on SGLT2 inhibitors have encouraged a shift towards considering these products – most specifically Vifor/Janssen’s Invokana (empagliflozin), as it was the first agent in the class to achieve a DKD indication.

The very recent approval of AstraZeneca’s SGLT2 inhibitor, Farxiga (dapagliflozin), for CKD patients with and without diabetes1, has created immense excitement among physicians as a potential game-changer in delaying CKD progression. While Invokana remains nephrologists’ preferred SGLT2 inhibitor, the gap has narrowed in recent quarters with Farxiga making substantial gains in the market as physicians grow more familiar with the agent. Additionally, new positive Phase III data from the FIGARO clinical trial for Bayer’s finerenone, demonstrating significantly reduced risk of cardiovascular death and events2 – along with the agent approaching its potential approval date – serve to further increase anticipation around new treatment options to improve outcomes for difficult-to-manage DKD patients.

The report included in Spherix’s new Special Topix™: Evolution of SGLT2 Inhibitors in DKD and Beyond service encompasses more than a year of data gathered from Spherix’s RealTime Dynamix™ and Market Dynamix™ services to better understand the evolution of the SGLT2 inhibitor market from the perspective of nephrologists, endocrinologists, cardiologists, and primary care physicians (PCPs). To add insights and perspective to the data and trends, Spherix also conducted more than 20 in-depth interviews across participating physicians, as well as managed care payers.

This new Special Topix™ service also leverages data from Spherix’s RealWorld Dynamix™ large-scale chart audits, including 1,030 CKD non-dialysis patients currently managed by nephrologists and 1,009 CKD non-dialysis patients currently managed by PCPs. Patient-level data provides symptoms, comorbidities, and lab values for DKD and non-diabetic CKD patients and allows subscribers to better understand not only those patients currently on SGLT2 inhibitors, but differences in care between nephrologists and PCPs and how treatment with SGLT2 inhibitors is likely to evolve.

Overall, physicians across specialties state that they intend to increase their use of SGLT2 inhibitors in the near-term. Most agree that patients do not need to have diabetes to benefit from SGLT2 inhibitors, indicating there is likelihood that agents in the class will be used more broadly, potentially changing the face of CKD management.

However, Spherix predicts this will be a slow adoption and a game of push and pull – while nephrologists in particular seem ready to embrace SGLT2 inhibitors, many still remain trepidatious about prescribing the products. One responding nephrologist noted: “I’m concerned whether indeed the benefit of these drugs in non-diabetic CKD patients outweighs the risks and side effects in this population.”

Other nephrologists note that they do not feel comfortable or want to manage a patient’s diabetes and are concerned about hypoglycemia. Consistently, one-third of nephrologists have mentioned that they continue to have some trepidation about prescribing SGLT2 inhibitors in their DKD patients, and even as of April 2021, that percentage is higher when they consider prescribing SGLT2 inhibitors in their non-diabetic CKD patients.

Other pipeline products for the treatment of DKD, such as finerenone and Ozempic (Novo Nordisk) also show promise, as nephrologists show preference for finerenone, while endocrinologists and PCPs lean in favor of Ozempic. The approval of these products may shake up the DKD and CKD markets even more as physicians navigate the co-management of patients and potential changes to standard of care with these emerging therapies.

Spherix will be closely tracking quarterly changes in the SGLT2 inhibitor market, for both diabetic and non-diabetic CKD patients, through their RealTime Dynamix™: Chronic Kidney Disease (US) service. Once approved, DKD pipeline products, such as finerenone, will be tracked for the first eighteen months of commercial availability via Spherix’s Launch Dynamix™ service, which includes uptake and market reception in monthly updates on key performance factors and quarterly deep dive reports that capture qualitative and quantitative analyses.

About Spherix’s Services
Special Topix™: Evolution of SGLT2 Inhibitors in DKD and Beyond service includes access to a report that encompasses a year and a half worth of data from Spherix’s RealTime Dynamix™, Market Dynamix™, and RealWorld Dynamix™ services to better understand the evolution of the SGLT2 inhibitor market from the perspective of nephrologists, endocrinologists, cardiologists, and primary care physicians, along with managed care payers.

 RealTime Dynamix is an independent service providing strategic guidance through quarterly or semiannual reports, which include market trending and a fresh infusion of event-driven and variable content with each wave. The reports provide an unbiased view of the competitive landscape within rapidly evolving specialty markets, fueled by robust HCP primary research and our in-house team of experts.

Market Dynamix™ is an independent service providing analysis of markets anticipated to experience a paradigm shift within the next three to five years, highlighting market size, current treatment approaches, unmet needs, and expert opinions on the likely disruption introduced by pipeline agents.

RealWorld Dynamix™ is an independent, data-driven service unveiling real patient management patterns through rigorous analysis of large-scale patient chart audits. Insights reveal the “why” behind treatment decisions, include year over year trending to quantify key aspects of market evolution, and integrate specialists’ attitudinal & demographic data to highlight differences between stated and actual treatment patterns.

 Launch Dynamix™ is an independent service providing a monthly benchmarking of newly launched products for the first eighteen months of commercial availability, augmented by a quarterly deep dive into patient types initiated, brand perceptions, promotional activity, and drivers and barriers to uptake.

About Spherix Global Insights
Spherix Global Insights is a hyper-focused market intelligence firm that leverages our own independent data and expertise to provide strategic guidance, so biopharma stakeholders make decisions with confidence. We specialize in select immunology, nephrology, and neurology markets.

All company, brand or product names in this document are trademarks of their respective holders.



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