From ‘CVMD’ to ‘CVRM’ – Bringing Renal into Focus in our Approach to Cardiovascular, Renal and Metabolism

AUTHOR

Elisabeth Bjork, Vice President, Head of Cardiovascular, Renal and Metabolism (CVRM), Global Medicines Development

Chronic kidney disease (CKD) affects 1 in 10 people globally and its prevalence is increasing with the rise of risk factors like hypertension, atherosclerosis, heart failure and diabetes. 1,2,3,4,5,6 Research continues to point towards common underlying mechanisms and relationships behind these diseases. 2 For this reason, we are taking a distinctive cardio-renal-metabolic (CaReMe) approach by evaluating these diseases holistically and addressing patients’ multiple risk factors together.

To reflect this, our therapy area previously known as “CVMD” is now renamed to CVRM, recognising the importance of renal within our pipeline. With our leading science and pipeline of potentially first-in-class medicines, renal disease is now a major component of our CVRM strategy to address the unmet need for CKD patients who have often faced a bleak future.

CaReMe diseases critically impact patients’ quality of life and overall health outcomes. Cardiovascular disease (CVD), CKD and diabetes are among the most common causes of deaths in many countries in 2014. 7 Deaths due to CKD specifically more than doubled between 1990 and 2013, and 47% of CKD-related deaths in 2013 were either the result of chronic hypertension or attributable to diabetes-related complications. 8 Renal patients are at risk for life-threatening complications, with even small decreases in renal function leading to an increased risk of death and CV-related complications once moderate renal dysfunction has been reached (eGFR <60 ml per minute per 1.73m2 ). 9 In fact, CVD is the leading cause of death in people with CKD and those suffering from CKD are up to 20 times more likely to die from cardiac causes.10,11 This risk is largely due to the close clinical relationship between the kidney and heart – cardiac damage increases one’s susceptibility to kidney damage and can accelerate the progression of CKD, and in turn, chronic renal damage can cause cardiac dysfunction, among other issues. 12

Despite the close associations between CaReMe disease states, shared risk factors are often not diagnosed or addressed in individual patients. The many clinical associations observed between CaReMe disease states provide an opportunity for education, improved treatment and better outcomes. With these critical needs in mind, our cardio-renal strategy focuses on addressing the management of the serious complications of CKD such as hyperkalaemia and renal anaemia; exploring therapies that could prevent CKD or modify progression; and aiming to address residual unmet needs in CKD.

With our current portfolio and pipeline, our aim is to continue advancing new CVRM treatment options that have the potential to deliver improved outcomes to millions of patients across the globe.
 

References


1
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2 Ojo A. “Addressing the Global Burden of Chronic Kidney Disease Through Clinical and Translational Research. Trans Am Clin Climatol Assoc. 2014; 125:229-246.

3 International Diabetes Federation. IDF Diabetes Altas, 7th ed. Brussels, Belgium: International Diabetes Federation, 2015.

4 Hoerger TJ, Simpson SA, Yarnoff BO, et al. The Future Burden of CKD in the United States: A Simulation Model for the CDC CKD Initiative.” Am J Kidney Dis. 2015; 65: 403-411.

5 IOM (Institutes of Medicine). 2010. Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health. Washington, DC: The National Academic Press.

6 Kidney Research UK. Atherosclerotic Renovascular Disease. Accessed 8 March 2018. https://www.kidneyresearchuk.org/health-information/ckd-information/atherosclerotic-renovascular-disease. 

7 Centers for Disease Control and Prevention. National Vital Statistics Reports. 2016; 65 (4):1-122. Accessed 7 March 2018. https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf.

8 GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385:117–171

9 Go AS, Chertow GM, Fan D et al. Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and Hospitalization. N Engl J Med. 2004;351:1296-1305

10 National Institutes of Health. Chronic Kidney Disease and Kidney Failure. Accessed 7 March 2018. https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=34.

11 Bongartz LG, Cramer MJ, Doevendans PA, et al. The severe cardiorenal syndrome: ‘Guyton revisted’. Eur Heart J. 2005;26:11–17.

12 Ronco C, Haapio M, House AA, et al. Cardiorenal Syndrome. JACC. 2008;52:1527–1539.