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Akebia Therapeutics' HIF-PH inhibitor passes efficacy goals in chronic kidney disease without dialysis, but falls short on safety

Published on 04/09/20 at 10:50am

Akebia Therapeutics has pulled back the veil on data from the second of two Phase 3 clinical trials for its oral hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) vadadustat, showing that the therapy met its primary and secondary efficacy goals in the treatment of anaemia due to chronic kidney disease (CKD) in adult patients who are not receiving dialysis.

According to the data from the PRO2TECT study, vadadustat proved non-inferior to darbepoetin alfa in terms of average change from baseline in haemoglobin levels at two evaluated points in the study: between weeks 24 and 36 following initial dose, and between weeks 40 and 52.

However, the drug fell short of its primary safety goal, failing to match up to darbepoetin alfa in terms of the time until patients first suffered a major adverse cardiovascular events (MACE), the composite of all-cause mortality, non-fatal myocardial infarction, and non-fatal stroke across this study and its partner study.

"PRO2TECT delivered positive top-line efficacy results; however, the MACE result presents challenges to achieving our goal of bringing vadadustat to patients in the non-dialysis market. While achieving the MACE endpoint would have made our path here more straightforward, as it is in dialysis, we still believe we have a path toward approval for vadadustat in non-dialysis," explained Akebia President and CEO John P Butler. "We believe the cardiovascular safety of vadadustat is supported by the totality of the data from our global Phase 3 programme, including additional analyses on cardiovascular outcomes observed within key geographic regions and across certain patient sub-populations within PRO2TECT."

Akebia aims to present full data from the study at an upcoming medical meeting, and aims to file an application with the FDA “as early as possible” in 2021.

Matt Fellows

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