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Published on: June 23, 2015
Clinical Trials and a View Toward the Future of ADPKD
Hyunsuk Kim1, Young-Hwan Hwang2
1Department of Internal Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. keeee@hanmail.net.
Abstract:
In light of the advances in the understanding of cystogenesis in clinical syndromes, potential therapeutic targets have been proposed. Among ciliopathies, autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary disease, and is characterized by the progressive enlargement of bilateral renal cysts, resulting in end-stage kidney failure. Progress in genetics and molecular pathobiology has enabled the development of therapeutic agents that can modulate aberrant molecular pathways. Recently, clinical trials using somatostatin analogs and vasopressin receptor antagonists were conducted, and resulted in the approval of tolvaptan in managing kidney disease in some countries. We will summarize the developments of therapeutic agents based on pathogenesis, and discuss recent findings in clinical trials. Moreover, issues such as the timing of the intervention and outcome assessment will be discussed.
Insights
Autosomal dominant polycystic kidney disease (ADPKD) treatments are advancing. New therapies targeting cystogenesis pathways, like tolvaptan, show promise for managing this common inherited kidney disease.
Area of Science:
- Nephrology
- Genetics
- Molecular Biology
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) is a prevalent genetic disorder.
- It leads to progressive kidney cyst development and eventual kidney failure.
- Understanding cystogenesis has identified new therapeutic targets.
Purpose of the Study:
- To review therapeutic agents for ADPKD based on disease pathogenesis.
- To discuss recent clinical trial findings for ADPKD treatments.
- To explore intervention timing and outcome assessment in ADPKD management.
Main Methods:
- Literature review of ADPKD pathogenesis.
- Analysis of clinical trial data for somatostatin analogs and vasopressin receptor antagonists.
- Discussion of therapeutic strategies and outcome measures.
Main Results:
- Progress in understanding ADPKD has led to targeted therapies.
- Tolvaptan, a vasopressin receptor antagonist, is approved in some regions.
- Clinical trials are evaluating various agents modulating aberrant molecular pathways.
Conclusions:
- Therapeutic options for ADPKD are expanding based on molecular insights.
- Tolvaptan represents a significant advancement in managing ADPKD.
- Further research is needed on optimal intervention timing and outcome assessment.
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