Kidney Week Wraps With Presentations on COVID and Emerging Therapies

In this interview, Dr. Bradley Marder, medical director of nephrology with Horizon Therapeutics, offers his take on the most memorable moments from the American Society for Nephrology/Kidney Week annual meeting which wrapped this week.

“Kidney Week is a nephrologist’s favorite week of the year. This year, it was a virtual meeting because of the pandemic. Despite the fact that it was virtual, there was some really interesting new research presented at the meeting. What stood out to me were several new emerging therapies with clinical trial results regarding lupus nephritis. This is a topic that is interesting for both rheumatologists and nephrologists because we both take care of this patient population that suffers so much with this disease which can impact their lives tremendously.

“First, Brad Rovin, M.D., from The Ohio State University had a great presentation in which he presented some emerging trial data…It looks like that the addition of belimumab to standard induction therapy improves remission rates in patients with lupus nephritis―and that's very exciting.

“He also presented a poster regarding the new novel calcineurin inhibitor voclosporin, which, when added to standard therapy, also improves remission rates in lupus nephritis. This is actually very important because the European Renal Association uses calcineurin inhibitors as one of the potential treatment choices of induction for lupus nephritis. We all know that calcineurin inhibitors have quite a few side effects in their profile and so having a new agent in that class might really help more patients get successful treatments.

“And, then there is a new therapy which is a CD20 antagonist---a monoclonoal antibody called obinutuzumab. It is also enrolling in trials and it looks like it may be a very successful therapy in addition to standard therapy for these patients with lupus as well.

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“These are very exciting new agents that come at a time when there really hasn't been a whole lot of new therapy options for these patients who are suffering from lupus," Dr. Marder said.

And, of course, COVID-19, was a big subject this year. Dr. Marder closes this interview citing a poster presentation from a physician at Cornell University who compared hospitalization to fatality rates in COVID-19 patients who had either a kidney transplant or were on a wait list.

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“It turns out that patients on the waiting had higher hospitalization rates and fatality rates than patients who had a kidney transplant and were taking immunosuppressive medications,” he said. “It’s very interesting to see that even though transplant patients were on immunosuppressives, they had lower hospitalization and fatality rates than patients who had not yet gotten their kidney transplant and who were not yet on those therapies. There are two possibilities here: Either patients with kidney transplants just become so much healthier than patients who were on dialysis that they were not affected by the virus as much. Or, there is a potential that the immunosuppressant medications that patients take for their transplant may have some benefit for patients in lessening the immunologic reaction that the body has to the viral infections.”