NephCure’s advocates have achieved a significant victory this summer, more than tripling the number of cosponsors for the New Era Act (H.R. 6790). Before NephCure’s Rare Kidneys On The Hill Day event on July 24, the New Era Act had the support of 10 members of Congress—an encouraging start, but a push was needed to gain real traction. Now, thanks to the tireless efforts of our advocacy community, that number has now surged to 37 co-sponsors for the New Era Act as of October 1st, 2024.
This unprecedented increase is a direct result of the dedication of NephCure advocates, who spent the summer contacting and engaging their congressional representatives, sharing their personal stories, discussing the The New Era Act’s impact, and explaining the urgent need for action. From phone calls to emails and face-to-face meetings, these advocates mobilized to make sure their voices — and the needs of the rare kidney disease community — were heard.
Their work demonstrates the profound impact that collective action can have in advancing critical legislation. The New Era Act, which aims to transform the treatment and prevention of end-stage kidney disease, now has the widespread support it needs to move forward, thanks to the persistent and passionate efforts of our community.
While this progress is a major milestone, there is still much work ahead. NephCure remains committed to pushing for the passage of the New Era Act and ensuring that patients with rare kidney diseases receive the attention, care, and support they deserve.
NephCure is deeply grateful to every advocate who helped make this possible and looks forward to continuing this fight together. Sign up for our monthly newsletter to stay updated as we move closer to making this life-changing legislation a reality!
To see the full list of the most up to date New Era Act co-sponsors, click here.
In June 2024, Reykjavik, Iceland, became the focal point of a significant milestone in the fight against focal segmental glomerulosclerosis (FSGS), a rare kidney disease. The PARASOL Project, launched in December 2023 with the goal of providing data driven and feasible endpoints for the conduct FSGS clinical trials, held a pivotal meeting on June 8-9, 2024, bringing together leading experts and stakeholders from around the globe to assess progress and outline future strategies.
This marks the PARASOL Project’s second meeting which included researchers, clinicians, patient advocates, industry sponsors, biostatisticians and government regulatory experts. This collective came together to continue the work needed to be done in order to identify alternative endpoints for FSGS clinical trials— particularly considering that the FDA currently accepts complete remission or near normalization of proteinuria as a surrogate endpoint and basis of traditional approval of new treatments. An endpoint is an outcome that can be measured to determine if the treatment being studied is beneficial.
As more trials are underway or about to begin, there is a need to explore whether lesser changes in proteinuria can be used to support accelerated or traditional approval of new treatments.
The meeting focused on patient-level data assembled from cohorts and registries from around the globe. To date, more than 3,000 patients are represented from more than 20 cohorts that have committed their data, with four so far, fully integrated into the analysis—NEPTUNE, CureGN, Kidney Research Network (KRN), and UNC Glomerular Disease Collaborative Research Network (GDCRN). Additional cohorts are on track for inclusion pending administrative approvals by mid-August.
“We are truly inspired by the community’s response to PARASOL, especially the eagerness of nephrologists and their teams to share their data,” PARASOL Project Co-Chair, Dr. Matthias Kretzler said. “Each participating registry or patient cohort often identified additional sources of well-characterized FSGS patients who could potentially join the initiative.”
The collaborative atmosphere in Reykjavik fostered robust engagement among participants, emphasizing the urgency and potential impact of this work. Biostatisticians Margaret Helmuth, MS, and Abigail Smith, PhD, presented preliminary analyses setting the stage for focused breakout sessions and discussions about additional analyses in preparation to share key data deliverables at the October 2024 annual meeting of the American Society of Nephrology.
“It was incredibly gratifying to have such a diverse group of stakeholders all in one room, fostering robust and vital discussions,” said Josh Tarnoff, CEO of NephCure. “The range of perspectives—from FDA experts to patient advocates—was invaluable in emphasizing the importance of our shared repository and exploring how to develop an appropriate indicator for FSGS progression in trials to get treatments to those who are in great.”
The PARASOL Project is pioneering new approaches in the fight against FSGS, creating hope amongst the NephCure community for new, potential treatment options.
“With an amazing group of experts, we delved into strategies to improve endpoints to better serve patients, clinicians, and sponsors. Our discussions covered practical trial designs, analyzing complex pediatric patient data, and identifying specific patient subgroups to ensure our model holds up,” PARASOL Project Co-Chair, Dr. Laura Mariani explained.
The PARASOL project is sponsored by NephCure, International Society of Glomerular Diseases, National Kidney Foundation, and Kidney Health Initiative — and most recently, the U.S. Food and Drug Administration (FDA).
A third PARASOL project meeting will be held in Washington, D.C. on October 7-8, 2024, followed by broader dissemination at American Society of Nephrology Kidney Week later that month in San Diego.
If you would like to get involved further with the PARASOL project, or have additional questions, please direct all inquiries to info@nephcure.org.
August 8, 2024: Today marks a promising day for the rare kidney disease (RKD) community: the FDA has announced that Novartis’ drug, Fabhalta (iptacopan), has been granted accelerated approval for the treatment of IgA nephropathy in adults.
As background, the FDA’s accelerated approval program allows for earlier approval of drugs that treat serious conditions and fill an unmet medical need. Fabhalta is granted accelerated approval based on reduction of proteinuria. Further evaluations will determine if the drug slows kidney function decline in IgAN patients.
Over the next several months, Novartis will share more information about this new treatment and explain when and how those who need the drug can access it.
“The FDA’s accelerated approval of Fabhalta represents a critical advancement in addressing the serious and debilitating symptoms of IgA nephropathy. It adds another key option for the rare kidney disease community, as patients respond differently to various therapeutic agents, and we need more options offering different mechanisms of action,” said Josh Tarnoff, NephCure’s CEO.
“This is a momentous occasion that underscores the significant progress our community continues to make in developing effective treatments for this devastating disease. We know that our work is far from over, but these breakthroughs are critical to ensuring our patient community has increasing access to life-saving treatments. This is not just hope – this is a path paved forward.”
The continued approval of Fabhalta may be dependent upon the data from Novartis’ ongoing phase 3 APPLAUSE-IgAN study, which evaluates whether Fabhalta slows disease progression as measured by estimated glomerular filtration rate (eGFR) decline over 2 years. The eGFR data are expected at study completion in 2025 and are intended to support traditional FDA approval.
Key takeaways regarding Fabhalta:
Fabhalta achieved a 44% proteinuria reduction from baseline in Phase III APPLAUSE-IgAN interim analysis, compared with 9% in placebo arm, demonstrating a clinically meaningful reduction of 38% vs. placebo.
Fabhalta is an inhibitor of the alternative complement pathway, activation of which is thought to contribute to the pathogenesis of IgAN.
Despite current standard of care, up to 50% of IgAN patients with persistent proteinuria progress to kidney failure within 10 to 20 years of diagnosis.
This marks the first approval from Novartis’ renal pipeline, which also includes atrasentan and zigakibart.
Fabhalta is also being developed to treat several other rare diseases beyond IgA nephropathy (IgAN), such as C3 glomerulopathy (C3G), atypical hemolytic uremic syndrome (aHUS), immune complex membranoproliferative glomerulonephritis (IC-MPGN), and lupus nephritis (LN). Ongoing studies are assessing its safety and effectiveness for these conditions to support potential regulatory approvals. The company plans to submit Fabhalta to the FDA and EMA for C3G treatment by the end of the year.
While we celebrate the FDA’s accelerated approval of Fabhalta, we also continue to move forward to ensure continued access to treatments like this. Our focus now turns to ensuring all patients have timely and equitable access to this new and promising treatment.
NephCure remains steadfast in our mission to empower people with protein-spilling kidney conditions to take charge of their health, while leading the revolution in research, new treatments, and care.
We are deeply grateful for the incredible support that has helped our community reach this pivotal moment, and we are more committed than ever to the important work ahead. There is still much to be done, but today’s news gives us hope and determination to deliver on our promise to the rare kidney disease community.
On December 9, 2023, researchers, doctors, regulators, and patients from across the globe met in Washington, D.C. at the Proteinuria and GFR as Clinical Trial Endpoints in Focal Segmental Glomerulosclerosis (PARASOL) Project to discuss developing biostatistical models that could help with the design of clinical trials and aid subsequent regulatory approval of new treatments for FSGS.
FSGS is a challenging disease to study because of the diverse patient population who experience different symptoms, response to treatments and rates of progression.
Two important things doctors measure are protein in the urine (proteinuria) and kidney function (eGFR). But these can fluctuate a lot in FSGS. At this meeting, the group discussed how to account for this variability in their statistical models of disease course.
PARASOL project attendees also considered what outcomes the models should predict, like kidney failure. Linking changes in proteinuria or GFR to these outcomes could help identify new treatments more quickly.
“We recognize the urgent need for innovative additonal approaches to study FSGS. As we navigate the complexities of this challenging disease, the collaboration among global experts is key. By developing precise mathematical models, we aim to not only categorize patient groups more effectively, but also better predict outcomes like kidney failure. The entire PARASOL team is committed to providing regulatory agencies and drug companies data driven and feasible tools for better clinical trials and testing new FSGS therapies,” Josh Tarnoff, NephCure’s CEO, said.
Participants agreed that to achieve these goals, they would need to bring together research datasets from all over the world to make sure that the models work for all patients with FSGS. By reviewing data, they hope to make decisions to start building initial models.
Their models aim to provide a practical tool for drug companies to design clinical trials that could test new FSGS therapies and improve options for patients.
The PARASOL project is sponsored by NephCure, International Society of Glomerular Diseases, National Kidney Foundation, and Kidney Health Initiative.
There are plans for researchers and doctors to attend a follow up PARASOL project in June 2024, and to present project outcomes at the American Society of Nephrology project in late 2024.
If you would like to get involved further with the PARASOL project, or have additional questions, please direct all inquires to info@nephcure.org.
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