Rabu, 25 Oktober 2017

MENTOR Results, New Trial Design Pitches at Kidney Week

MENTOR Results, New Trial Design Pitches at Kidney Week


NEW ORLEANS — Results from the MENTOR trial, a randomized comparison of rituximab and cyclosporine for the treatment of membranous nephropathy, will be in the spotlight here at Kidney Week 2017.

The noninferiority study looked at the long-term remission of proteinuria in patients with this challenging disease.



Dr Patrick Nachman

Also of interest will be a pragmatic clinical trial demonstration project from the National Institutes of Health, said Patrick Nachman, MD, from the University of North Carolina Kidney Center in Chapel Hill, who is chair of the ASN postgraduate education committee.

The “results may give us an idea of how we can think about clinical trials differently than the traditional randomized trial, which of course has benefits, but also some limitations,” he told Medscape Medical News.

During the high-impact clinical trials session, studies will be presented on a new candidate molecule for the prevention of acute kidney injury after cardiac surgery; the use of ultrasound-guided percutaneous arteriovenous fistula to improve hemodialysis access; and whether or not tolvaptan (Samsca, Otsuka Pharmaceutical), a vasopressin receptor 2 antagonist, can slow the inevitable decline in kidney function in patients with later-stage autosomal dominant polycystic kidney disease.

And new analyses of data from big name clinical trials — such as the EMPA-REG OUTCOME trial and the Peritoneal Dialysis Outcomes and Practice Patterns Study — will be presented.

The effective prevention of kidney injury after the use of either intravenous or intracoronary contrast agents during coronary angiography will be addressed in an industry-independent phase 3 clinical trial.

And far more common problems in nephrology will be addressed in another presentation, such as whether drinking more water can prevent recurrent cystitis in women.

“Nephrology is an incredibly rich subspecialty of medicine,” said Dr Nachman. “This year we have received what I believe is a record number of very high-caliber, excellent studies covering the breadth and depth of clinical issues in the field.”



Dr Susan Wall

Basic science interests will be amply represented at the meeting. “The state-of-the-art lectures are very bench-to-bedside,” said Susan Wall, MD, from the Emory School of Medicine in Atlanta, who is chair of the ASN scientific committee.

Dr Wall, who is a basic scientist herself, singled out several cutting-edge lectures.

Laura Niklason, MD, PhD, from the Yale School of Medicine in New Haven, Connecticut, will discuss how her early research into stem cells took her all the way to clinical trials designed to evaluate human-engineered tissue for the creation of dialysis access.

And Brian Kobilka, MD, from the Stanford University School of Medicine in California, will discuss his Nobel Prize–winning discovery of G-protein-coupled receptors, the largest family of receptors for hormones and neurotransmitters in the human genome. These particular receptors mediate most cellular responses to hormones and neurotransmitters and, as such, are key molecular candidates for new drug discovery.

“Really exciting things are being done right now in nephrology, and the ASN has traditionally been the major forum at which these major advances are presented,” said Dr Wall.

“When we go to work every day, we end up being focused on our own little niche, so I love the lectures because they open my eyes to lines of work that I am not engaged in and that give me a better understanding of what’s going on,” said Dr Nachman.

“It’s just so amazing to see how excited people are about their own work in so many different aspects of nephrology,” he added.

The Nephron Challenge

For attendees looking for a break from the more serious sessions, innovative on-site experiences will be used to present different aspects of nephrology.

For example, the Nephron Challenge uses a Jeopardy-style format — in which teams of participants respond to statements posed by the moderator in the form of questions — to test medical knowledge.

In addition, presenters will share lessons on how to move education out of the classroom and into an online game format, and demonstrate GlomCon, a web-based video platform that uses peer-to-peer clinical exchanges to increase the exposure of nephrologists around the world to glomerular disorders.

Dr Nachman reports receiving research funding from ChemoCentryx, Genentech, and Otsuka, and honoraria from Clearview. Dr Wall reports stock ownership in Johnson & Johnson, Becton Dickinson, Merck, Gilead Pharmaceuticals, and Abbott.

Follow Medscape on Twitter @Medscape



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