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Multimarker Panels in Diabetic Kidney Disease: The Way to Improved Clinical Trial Design and Clinical Practice?

Paul Perco1, Michelle Pena2, Hiddo J L Heerspink2

  • 1Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria.

Kidney International Reports
|February 19, 2019
PubMed

Insights

Diabetic kidney disease (DKD) requires personalized treatment. Molecular marker panels in platform trials can guide tailored therapies by matching patients to optimal treatment arms based on their unique disease profiles.

Area of Science:

  • Nephrology
  • Molecular Biology
  • Clinical Trials

Background:

  • Diabetic kidney disease (DKD) is a complex condition with multifactorial molecular pathway deregulation.
  • Current biomarkers like eGFR and albuminuria are insufficient for personalized DKD therapy.
  • Understanding drug interactions with disease pathways is crucial for DKD treatment.

Purpose of the Study:

  • To propose molecular multimarker panels for DKD patient stratification in platform trials.
  • To outline methods for modeling DKD pathophysiology to support biomarker panel development.
  • To discuss the integration of biomarkers into clinical trial designs for DKD.

Main Methods:

  • Reviewing evidence on DKD progression and therapy response variations.
  • Developing procedures for modeling DKD pathophysiology.
  • Integrating molecular marker profiles for patient assignment in platform trials.
  • Monitoring biomarkers and renal function to guide treatment adjustments.

Main Results:

  • Molecular panels offer a basis for tailored DKD therapy, moving beyond traditional biomarkers.
  • Platform trials enable dynamic patient assignment to optimal treatment arms based on molecular profiles.
  • Biomarker monitoring facilitates identification of therapy responders and facilitates switching non-responders.

Conclusions:

  • Personalized medicine in DKD can be advanced through molecular multimarker panels and platform trials.
  • Biomarker-driven patient stratification improves treatment efficacy and trial efficiency.
  • Future DKD clinical trials should leverage molecular profiling for optimized therapeutic strategies.
Keywords:
biomarker panelclinical trial designdiabetic kidney diseasepathophysiologypredictive marker

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