Lumasiran is in clinical development for the treatment of primary hyperoxaluria type I (PH1). PH1 is a very rare disease caused by certain genetic mutations, in which excess oxalate production results in the deposition of oxalate crystals in the kidneys and urinary tract. This leads to stone formation and kidney failure with significant morbidity and mortality. Treatment options for PH1 include vitamin B6 which is known to reduce the body’s production of oxalate, dietary recommendations to prevent kidney stones and combined liver-kidney transplantation before or after development of end-stage kidney failure.
Lumasiran, which is administered as a subcutaneous injection, is designed to reduce the levels of an enzyme called glycolate oxidase produced by the liver. Oxalate production is therefore inhibited. By reducing oxalate production, lumasiran has the potential to prevent the actual disease process that develops in PH1. If licensed, lumasiran may provide the first pharmacological treatment option for patients with PH1 who do not have any approved treatment.
Difelikefalin is a potent kappa opioid receptor agonist that is an itch and inflammation suppressant. Difelikefalin intravenous injection acts as an itch and inflammation suppressant without the undesirable side-effects typical of a centrally-acting opioid medicine such as hallucinations or opioid addiction. If licensed, difelikefalin will offer an additional treatment option for adult haemodialysis patients with moderate to severe CKD-aP who currently have few effective therapies available.