Thousands of patients with chronic kidney disease are likely to benefit from a drug that can dramatically reduce the need for dialysis or a transplant.
Empagliflozin, taken daily, slows the progression of the devastating condition which affects as many as one in ten people in Britain.
Kidney disease is usually caused by the damage caused by another disease, such as type 1 and type 2 diabetes or high blood pressure. It means that the kidneys, which normally filter waste products from the body through urine, gradually stop working, leading to symptoms such as fatigue, swelling of the ankles, feet or hands and nausea – and eventually heart attacks and strokes.
There is no cure and some patients ultimately need dialysis – connected to a machine that cleans the blood several times a week – or a kidney transplant.
Thousands of patients with chronic kidney disease are likely to benefit from a drug that could dramatically reduce the need for dialysis or a transplant
As kidney disease develops, it can lead to patients needing dialysis and a possible transplant
Despite killing around 45,000 people every year in Britain, there are few effective treatment options available to kidney specialists, known as nephrologists.
But empagliflozin, which is already used to treat type 2 diabetes and costs around £1 per pill, is part of a new class of drugs called SGLT2 inhibitors, which have been shown to work against diabetes, kidney disease and even heart failure .
After trial results showed the drug was highly effective, regulators at the National Institute for Health and Care Excellence (NICE) accelerated approval for its use and announced it will be available to 226,000 people in the new year England and Wales.
The Empa-Kidney study, led by the University of Oxford, found it could slow the progression of the disease or death from cardiovascular disease by around 28 percent. Cardiovascular disease is one of the leading causes of death and disability for patients with the condition.
Professor Will Herrington, lead researcher on the study, says the new drugs are probably the most important development for chronic kidney disease in more than two decades. “It's a double victory for kidney patients,” he adds. 'We now have amazing information from studies suggesting that these drugs have truly remarkable effects on the kidneys and heart. When these results were presented at conferences, some nephrologists were moved to tears.
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'We've gone from telling patients that we can't stop the disease from progressing to saying that many of them may not need dialysis or a transplant for years – it's a revolution in healthcare.'
Empagliflozin works by blocking the absorption of sugar and salt by the kidneys and flushing them out in the urine. This lowers blood sugar levels, making it useful for diabetics, and reduces strain on kidney function. Its individual effect on the function of the heart is not yet well understood, but it may be a result of lowering salt levels, lowering blood pressure and the accumulation of excess body water.
Dr. Aisling McMahon, of Kidney Research UK, says the growing number of patients who will need dialysis over the next decade 'risks overwhelming the NHS unless urgent action is taken', and that the recommendation for empagliflozin 'is an important step in was the right direction'. direction'.
Angela Riley, 52, from Glasgow, who has advanced chronic kidney disease and needs dialysis three times a week, says empagliflozin gives her 'huge hope'.
“My life has been turned upside down by this condition,” she says. 'My legs became so swollen that I could no longer wear shoes and every movement was extremely painful. I can't walk or stand easily, I'm out of breath, dizzy and have no appetite.
'I have had to give up my job and will need dialysis for the rest of my life unless I get a transplant.
“With this drug, many people, like I was two or three years ago, may never have dialysis or a transplant again,” she adds. 'It is not a cure, but it can reduce the impact of this disease on patients, society and the NHS.'
There are also other medications emerging to treat kidney disease, including a new class of medications known as aldosterone synthase inhibitors that have already shown promising results in studies when given alongside empagliflozin.