touchPANEL DISCUSSION Progress in the management of CKD in patients with type 2 diabetes: How might non-steroidal MRAs change the treatment paradigm?
Experts discuss the evidence for non-steroidal mineralocorticoid receptor antagonists (MRAs) as an additional treatment option for patients with type 2 diabetes (T2D) and chronic kidney disease (CKD).
Prof. Christoph Wanner
University Hospital of Würzburg, Würzburg, Germany
CHAIR
Panelists:
Introduction
Chair, Prof. Wanner, introduces the expert panel and agenda for this discussion on how non-steroidal mineralocorticoid receptor antagonists might change the treatment paradigm for patients with type 2 diabetes and chronic kidney disease.
view bio and disclosures 1/4 Next ChapterWhy does the treatment landscape for patients with T2D and CKD still require novel therapies?
The panel considers the burden of disease in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD) and current treatment approaches to slow CKD progression, limitations of current treatments for T2D and CKD, and the unmet treatment need.
view bio and disclosures 2/4 Next ChapterWhy are non-steroidal MRAs being investigated in patients with T2D and CKD and what do the latest data show?
The panel discusses the rationale for blockade of the mineralocorticoid receptor in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD), properties of steroidal versus non-steroidal mineralocorticoid receptor antagonists (MRAs), and the latest data for non-steroidal MRAs in patients with T2D and microalbuminuria/CKD.
view bio and disclosures 3/4 Next ChapterHow might non-steroidal MRAs address unmet needs in T2D and CKD and fit into the current treatment paradigm?
The panel considers trial designs and efficacy and safety outcomes across the FIDELIO-DKD, FIGARO-DKD, DAPA-CKD and CREDENCE trials, how non-steroidal mineralocorticoid receptor agonists might address unmet treatment needs, and how they might be integrated into future clinical practice.
view bio and disclosures 4/4 Take CE/CME TestOverview & Learning Objectives
Overview
In this activity the expert panel will discuss three clinical themes covering unmet treatment needs for patients with T2D and CKD, the rationale and evidence for nonsteroidal MRAs and how they may best be incorporated into the treatment pathway for T2D and CKD.
This activity is jointly provided by USF Health and touchIME.
Target Audience
Endocrinologists, diabetologists, nephrologists, cardiologists and primary care physicians globally, with a focus on the EU, USA, Brazil and Canada.
Disclosures
All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.
Faculty
Christoph Wanner, MD discloses Advisory Board/Panel fees from AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly and Company and MSD. Grants/Research support from Boehringer Ingelheim (Terminated).
Janet McGill, MD, MA FACE, FACP discloses Advisory Board/Panel fees from Bayer, Eli Lilly and Company (Terminated) and Salix Pharmaceuticals (Terminated). Consultant fees from Boehringer Ingelheim (Terminated). Consultant/Grants/Research fees or support from Dexcom (Terminated). Grants/Research support from Beta Bionics, Medtronic and Novo Nordisk. Speaker’s Bureau fees from Janssen (Terminated).
Javed Butler, MD, MPH, MBA discloses Consultant fees from Abbott, Adrenomed, Amgen, Applied Therapeutics, Array BioPharma, Bayer, Boehringer Ingelheim, CVRx, G3 Pharma, Impulse Dynamics, Innolife, Luitpold Pharmaceuticals, Inc., Medtronic, Merck, Novo Nordisk, Relypsa, Seguana Medical and Vifor. Consultant/Speaker’s Bureau fees from AstraZeneca, Janssen and Novartis.
Content reviewer
Christy Thai, PharmD, BCPS has no relevant financial relationships to disclose.
Touch Medical Director
Sola Neunie has no financial interests/relationships or affiliations in relation to this activity.
USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.
Requirements for Successful Completion
In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.
If you have questions regarding credit please contact cpdsupport@usf.edu
Accreditations
Physicians
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.
USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu)
Advanced Practice Providers
Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.
The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.
Date of original release: 01 November 2021. Date credits expire: 01 November 2022.
If you have any questions regarding credit please contact cpdsupport@usf.edu
Learning Objectives
After watching this activity, participants should be better able to:
- Evaluate the need for new treatment options for patients with T2D and CKD
- Justify the use of MRAs in patients with T2D and CKD and describe the cardiorenal efficacy and safety of new and emerging nonsteroidal MRAs
- Appraise how nonsteroidal MRAs can address unmet needs in patients with T2D and CKD and fit into the current treatment paradigm
Faculty & Disclosures
Prof. Christoph Wanner
University Hospital of Würzburg, Würzburg, Germany
Prof. Christoph Wanner is Professor of Medicine and Head of the Division of Nephrology at the University Hospital of Würzburg, Germany.
His research in the field of diabetic kidney disease, lipid disorders and rare kidney diseases has been published in more than 800 PubMed-referenced scientific papers and articles (Hirsch Index 92). He was Principal Investigator on the 4D study and steering committee member of the SHARP and REVEAL trials. He is also steering committee member of the EMPA-REG Outcome, EMPEROR and EMPA-KIDNEY studies, as well as the CARMELINA trial and the FIGARO-/FIDELIO-DKD studies aimed at slowing the progression of kidney disease and improving cardiovascular outcomes. read more
He is a member of several editorial boards of kidney journals and has been Associate Editor of the Clinical Journal of the American Society of Nephrology, as well as Editor-in-Chief of the Journal of Renal Nutrition, until recently.
In 2012, he received a doctorate honoris causa from the Charles University of Prague. He has received the 2016 Award from the European Renal Association-European Dialysis and Transplant Association for Outstanding Clinical Contributions to Nephrology, and in 2018, the Franz Volhard medal, the highest award from the German Society of Nephrology. Prof. Wanner is President of the European Renal Association, being in office from June 2020–2023.
Christoph Wanner, MD discloses Advisory Board/Panel fees from AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly and Company and MSD. Grants/Research support from Boehringer Ingelheim (Terminated).
Prof. Janet McGill
Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
Janet McGill is Professor of Medicine in the Division of Endocrinology, Metabolism and Lipid Research at Washington University School of Medicine, and attending physician at Barnes-Jewish Hospital in St. Louis, Missouri.
She is currently the principal investigator of the National Institutes of Health (NIH)-funded GRADE study and the Insulin-Only Bionic Pancreas Pivotal Trial. She is a sub-investigator on the RADIANT study, which hopes to discover genetic causes of diabetes with atypical features through deep phenotyping and genotyping. read more
Prof. McGill has conducted over 220 clinical trials in type 1 and type 2 diabetes, studying new treatments and complications such as hypertension, hyperlipidaemia, nephropathy, neuropathy and retinopathy. She was the Principal Investigator (PI) of the NIH-funded PERL study, “Preventing Early Renal Loss in Type 1 Diabetes” and a continuous glucose monitoring sub-study, also the WISDM and recently published MOBILE studies. She led the Washington University site for the T1D Exchange clinic registry, and was the PI for several T1D Exchange clinical trials and registry studies. Prof. McGill has served on steering committees and data safety and monitoring boards for long-term outcome studies, both NIH- and industry-sponsored, and leads data safety committees locally for investigator-initiated studies.
Prof. McGill has published over 200 peer-reviewed articles, numerous commentaries and editorials, 25 book chapters, and she has edited four books, including the recently published books, Atypical Diabetes and the Washington Manual, Endocrine Subspecialty Consult, fourth edition. She has served on the editorial boards of several journals, and has lectured nationally and internationally on diabetes and related topics.
Prof. McGill served on the board of directors of the American Association of Clinical Endocrinology and the American College of Endocrinology, and is active in the Endocrine Society and the American Diabetes Association. She is a member of the Alpha Omega Alpha Honor Medical Society, and has received the Distinguished Clinician Award, the Alumni Achievement Award and the Endocrine Fellows’ Teaching Award from her peers at Washington University.
Janet McGill, MD, MA FACE, FACP discloses Advisory Board/Panel fees from Bayer, Eli Lilly and Company (Terminated) and Salix Pharmaceuticals (Terminated). Consultant fees from Boehringer Ingelheim (Terminated). Consultant/Grants/Research fees or support from Dexcom (Terminated). Grants/Research support from Beta Bionics, Medtronic and Novo Nordisk. Speaker’s Bureau fees from Janssen (Terminated).
Prof. Javed Butler
Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
Javed Butler, MD, MPH, MBA, is the Patrick H. Lehan Chair in Cardiovascular Research, and Professor and Chairman of the Department of Medicine at the University of Mississippi Medical Center in Jackson, MS. He is also Professor of Physiology. Prior to joining the University of Mississippi, he was Charles A. Gargano Professor and Director of the Division of Cardiovascular Medicine and Co-Director of the Heart Institute at Stony Brook University, New York. He had served as the director for heart failure research at Emory University and director of the heart and heart-lung transplant programs at Vanderbilt University prior to that. read more
He received his medical degree from the Aga Khan University and then completed residency training at Yale University, cardiology fellowship and advanced heart failure and transplant fellowships at Vanderbilt University, and cardiac imaging fellowship at the Massachusetts General Hospital at the Harvard Medical School. He has completed a Master of Public Health degree from Harvard University and a Master in Business Administration from Emory University.
Prof. Butler is board certified in cardiovascular medicine, advanced heart failure and transplant medicine. His research interests focus on clinical trials in patients with heart failure. He serves on several national committees for the American College of Cardiology, American Heart Association, National Institutes of Health, US Food and Drug Administration, and the Heart Failure Society of America. He is the recipient of the Simon Dack Award by the American College of Cardiology, as well as the Time, Feeling, and Focus Award by the American Heart Association.
Prof. Butler has authored more than 700 peer-reviewed publications. He serves on the editorial board of several peer reviewed cardiovascular journals. He has been cited numerous times in America’s Best Doctors list.
Javed Butler, MD, MPH, MBA discloses Consultant fees from Abbott, Adrenomed, Amgen, Applied Therapeutics, Array BioPharma, Bayer, Boehringer Ingelheim, CVRx, G3 Pharma, Impulse Dynamics, Innolife, Luitpold Pharmaceuticals, Inc., Medtronic, Merck, Novo Nordisk, Relypsa, Seguana Medical and Vifor. Consultant/Speaker’s Bureau fees from AstraZeneca, Janssen and Novartis.
