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Advancing Pediatric Kidney Disease Research: Building on the July 2023 SGLT2i Workshop

In July 2023, a landmark workshop brought together clinicians, researchers, patient advocates, and industry stakeholders to discuss the significant need for pediatric-specific studies in chronic kidney disease (CKD), with specific  focus on extrapolation of adult study data with SGLT2 inhibitors (SGLT2i) for potential application to the pediatric kidney disease population. This collaborative effort was driven by a shared understanding: while SGLT2 inhibitors have demonstrated clear benefit in adult populations with glomerular diseases, much remains unknown about their safety and efficacy in children.

As a direct result of this workshop, there has been notable momentum among pharmaceutical companies toward initiating pediatric studies involving these agents. Several sponsors are now actively working to develop clinical trial programs targeting pediatric populations, with specific attention to children living with glomerular diseases and those affected by congenital anomalies of the kidney and urinary tract (CAKUT). This forward movement marks an important step in bridging the treatment gap for pediatric patients and ensuring equitable access to potentially life-changing therapies.

Below is the summary paragraph that reflects the focus and consensus from the July 2023 workshop:

A workshop in July 2023 addressed the need for and feasibility of a randomized clinical trial testing the efficacy of SGLT2i in pediatric patients with CKD. Children with glomerular diseases are similar to adults. However, there are significant knowledge gaps in understanding the mechanism of disease progression and response to treatment in children with congenital anomalies of the kidney and urinary tract (CAKUT). There was a consensus that both groups of children need to be studied. A manuscript is in preparation summarizing the workshop proceedings.

NephCure is committed to supporting this ongoing work and continues to advocate for the inclusion of pediatric patients in all areas of rare kidney disease research and treatment development. 

NephCure Celebrates Second Annual APOL1 Kidney Disease Awareness Day on April 29, 2025

NephCure, a leading nonprofit organization dedicated to finding better treatments and a cure for rare kidney diseases, is proud to announce the second annual APOL1 Kidney Disease Awareness Day, taking place on April 29, 2025. This day is dedicated to raising national awareness of APOL1 kidney disease, which is a genetic form of kidney disease that disproportionately affects people of African ancestry.

APOL1 kidney disease is caused by specific changes in the APOL1 gene, which can lead to an increased risk of developing kidney disease. People who inherit certain APOL1 gene variants may be more likely to develop kidney disease, making education, awareness, and advocacy around this condition critical for early intervention and equitable care.

To honor this important day, NephCure invites everyone to participate in the following awareness opportunities:

Join the Virtual Town Hall on April 29 at 7PM ET
NephCure will host a free, live virtual APOL1 Awareness Day Town Hall event featuring powerful perspectives and expert insights from leading voices in the kidney and health equity space, including:

  • Dr. Keisha Gibson, MD, MPH – A pediatric nephrologist from UNC Chapel Hill.
  • Corynne Corbett – Representing Black Health Matters.
  • Barbara Harrison, MS, CGC – A clinical genetic counselor from Harvard University.

Spread Awareness on Social Media
Download the toolkit and share NephCure’s APOL1 kidney disease awareness graphics and patient stories on your social media channels, don’t forget to tag @NephCure.

Fast Facts About APOL1 Kidney Disease:

  • African Americans make up 13% of the U.S. population, but account for nearly 35% of people with kidney failure in the U.S.
  • 1 in 8 African Americans is at risk of a genetic form of kidney disease (caused by the APOL1 gene mutations).
  • APOL1 kidney disease is particularly aggressive and currently has no FDA-approved treatments.
  • Approximately 40% of African Americans on dialysis have kidney failure caused by APOL1.

NephCure’s APOL1 Awareness Day efforts would not be possible without the generous support of its sponsors, Vertex Pharmaceuticals, AstraZeneca, and Maze Therapeutics.

To register for the Town Hall on April 29th and learn more about APOL1 awareness efforts, click here.

About NephCure:
NephCure’s mission is to empower people with rare, protein-spilling kidney disease to take charge of their health, while leading the revolution in research, new treatments, and care. Founded in 2000 by a group of committed patient parents, NephCure has invested more than $40 million in kidney disease research and helped create a landscape where there are now new treatments and more than 60 interventional drug trials for rare kidney diseases. NephCure is a U.S. tax exempt 501(c)(3) public charity.

The FDA Grants Accelerated Approval to Vanrafia, New Treatment Option for Adults with IgA Nephropathy

A major step forward has been made for the IgA Nephropathy (IgAN) community. Last week, the FDA granted accelerated approval to Vanrafia (atrasentan), Novartis’ therapy, for adults with primary IgAN at risk of rapid disease progression. This approval brings new hope to those affected by this progressive, rare kidney disease.

As background, the FDA’s accelerated approval program allows for earlier approval of drugs that treat serious conditions and fill an unmet medical need. 

IgA Nephropathy (IgAN) is a kidney disease in which Immunoglobulin A (IgA) builds up in the kidney. IgA is a protein in the blood and is also part of the immune system. Excess IgA can cause inflammation in the kidney and over time, this leads to scarring in the kidney tissue. The severity of kidney disease caused by IgAN varies from person to person. As IgAN progresses, it reduces the kidneys’ ability to filter waste from the blood.

Approval was granted based on interim results from Novartis’ Phase 3 ALIGN trial, which demonstrated a 36.1% reduction in proteinuria compared to placebo. Reductions were seen as early as Week 6 and sustained through Week 36. Vanrafia was also shown to have a favorable safety profile, with no new safety signals observed. Ongoing data from the ALIGN study will evaluate whether Vanrafia slows kidney function decline long-term, with final results expected in 2026.

With this latest announcement, there are now four FDA-approved therapies for IgAN — a major shift from just a few years ago:

  • FABHALTA (iptacopan) – Approved for C3G and IgAN
  • FILSPARI (sparsentan) – Approved for IgAN
  • TARPEYO (budesonide) – Approved for IgAN
  • VANRAFIA (atrasentan) – Approved for IgAN

These treatment options, each with different mechanisms of action, allow patients and their care teams to take a more personalized approach to managing this disease.

NephCure remains committed to supporting the IgAN community through continued education, research, and advocacy. While this is an exciting moment, we know the work is far from over. Our focus now turns to ensuring timely, affordable, and equitable access to these therapies for all who need them.

If you or a loved one has IgAN, we encourage you to speak with your doctor to determine which treatment may be right for you.

To read Novartis’ full press release about Vanrafia’s FDA approval, click here.

For more information on IgA Nephropathy, click here. To view and read the available resources about IgAN, please visit NephCure.org.

The FDA Approves FABHALTA, First Treatment Option for Adults with C3G

A historic milestone has been reached for the rare kidney disease (RKD) community — the FDA has approved the drug FABHALTA as the first-ever treatment option for adults with C3 glomerulopathy (C3G). This long-awaited approval brings new hope to patients and families affected by this devastating disease.

C3G is an ultra-rare, debilitating kidney disease that damages the glomeruli (the filtering units in the kidneys that help remove toxins from the blood) which can ultimately lead to kidney failure. Until now, there were no approved targeted treatment options available for C3G. 

“This approval marks a significant step forward in our collective goal to improve the outcomes of those affected by rare kidney diseases. For the first time, the C3G community has a therapy approved and designed specifically for their condition. This comes on the heels of groundbreaking advancements in IgAN, which underscores the current exciting new era of innovation in RKD treatments,” Josh Tarnoff, NephCure’s CEO said. 

FABHALTA’s approval for FABHALTA in C3G is based off Novartis’ Phase 3 study, APPEAR-C3G, which evaluated the efficacy and safety of the drug and demonstrated reduction in proteinuria, which was seen as early as 14 days. 

This marks the third FDA approval, in the U.S., for FABHALTA and its second within the Novartis’ kidney disease portfolio in less than a year. In August 2024, the drug received accelerated approval for IgA Nephropathy (IgAN)

A New Era of Kidney Care

With this latest breakthrough, there are now four FDA-approved therapies for rare kidney disease:

  • FABHALTA (iptacopan) – Approved for C3G and IgAN
  • FILSPARI (sparsentan) – Approved for IgAN
  • TARPEYO (budesonide) – Approved for IgAN

This approval marks an important advancement, but our work is far from over. NephCure remains committed to advancing research, advocacy, and patient education to further improve treatment options and outcomes for those with C3G and other rare kidney diseases. With more than 60 clinical trials in the RKD space, we anticipate even more new treatments to be approved in the near future. 

Now, the focus shifts to ensuring timely and equitable access to these new and better treatments for all patients.

If you or a loved one has C3G, we encourage you to speak with your doctor to determine if FABHALTA may be an appropriate treatment option for you. 

To read Novartis’ press release about FABHALTA’s approval for C3G, click here.

For more information on C3G and available resources, please visit NephCure.org.

NephCure Advocacy Efforts Yield Unprecedented Support for New Era Act 

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.

Reykjavik Meeting Propels PARASOL Project Forward in FSGS Treatment Revolution 

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

FDA Grants Fabhalta Accelerated Approval for Treatment of IgA Nephropathy in Adults

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. 

Global Collaboration at PARASOL Project Enhances FSGS Clinical Trials and Hope of New Treatment Options

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.