Astrazeneca’s SGLT2 inhibitor Farxiga is already marketed for types 1 and 2 diabetes, and looks set to be approved for heart failure, but today brought news of a possible fourth indication. The drug’s Dapa-CKD trial, in chronic kidney disease (CKD), has been halted for “overwhelming efficacy”. Perhaps the most important aspect of Dapa-CKD is that it recruited diabetics and non-diabetics alike; use in the latter population could allow Astra to overtake Johnson & Johnson’s SGLT2 rival, Invokana, which is already approved to treat CKD, but only in type 2 diabetics. Of course, without knowing the full data the extent to which diabetics drove the overall Dapa-CKD result is not clear, so scrutinising the full dataset should focus on the benefit in non-diabetics. Assuming that Farxiga has shown a strong result in this subgroup a vital consideration is the role of Lilly/Boehringer Ingelheim’s rival Jardiance. That drug’s CKD study, Empa-Kidney, also recruits all-comers, and reads out in 2022. Astra’s bull case is that Farxiga now has a two-year window in which to make headway.
|SGLT2 inhibitors in chronic kidney disease|
|Invokana||Johnson & Johnson||Credence||Type 2 diabetics||Reported, drug approved|
|Farxiga||Astrazeneca||Dapa-CKD||Diabetics & non-diabetics||Halted for efficacy|
|Zynquista||Lexicon||Scored||Type 2 diabetics||Halted for lack of funding and Covid-19 lockdown risk, after Sanofi scrapped deal|
|Jardiance||Lilly/Boehringer Ingelheim||Empa-Kidney||Diabetics & non-diabetics||Ends mid-2022|
|Source: EvaluatePharma & clinicaltrials.gov.|