IgA nephropathy (IgAN) also known as Berger’s disease is one of the most common kidney diseases, aside from those caused by high blood pressure or diabetes. It is an autoimmune (where the immune cells attack the body) disease affecting the kidneys. IgA antibodies are molecules made by immune cells which help stop intruders from attacking the body. IgAN is caused when faulty IgA molecules get trapped in the kidneys, stopping them from working properly. The trapped IgA also causes inflammation and damage to kidneys, which may build up over years and result in kidney failure. Symptoms of IgAN are not obvious and are usually identified following blood tests. Signs of IgAN include blood and protein in the urine and high blood pressure.
Budesonide is a steroid drug which reduces inflammation. Nefecon is a new oral formulation of budesonide that is designed to specifically deliver the drug to a place in the intestine where most of the immune cells producing IgA are located. This has the potential advantage of targeting the underlying process that causes IgAN with significantly fewer side effects when compared to the generally used systemic steroids such as prednisone, (which is delivered throughout the whole body). If licenced, Nefecon has the potential to become the first disease-specific treatment for IgAN.
Roxadustat is a product in development that can be taken orally as a tablet. It has the potential to stimulate the growth of red blood cells by increasing the body’s own production of EPO in patients with CKD who may be on dialysis or pre‐dialysis. If approved for the treatment of anaemia in this population, roxadustat will provide an alternative treatment option that offers a likely reduction in the need for supplemental iron as an advantage.