AstraZeneca presented new findings from the DISCOVER Chronic Kidney Disease (CKD) study at the American Society of Nephrologists (ASN) Kidney Week 2020 Congress last week.
The DISCOVER CKD study is characterising contemporary real-world management of CKD, to provides insights into the current gaps in treatment and management of CKD, as well as care pathways and novel endpoints.
The international hybrid observational cohort study, undertaken in collaboration with a scientific committee, includes both prospective and retrospective cohorts of patient with CKD.
It is assessing current, real-world practice patterns, clinical management and outcomes in the UK, US, Sweden, Italy, China and Japan. The study is also using mobile technology to allow patients to provide their own experiences with CKD and improve patient dialogue as well as assess AZ’s specific outcomes via prospective data collection.
The DISCOVER CKD study population for all countries except Japan includes male and female patients with CKD aged 18 years or over. In Japan, male or female patients over the age of 20 years are included.
In the initial key findings, AZ found that over 600,000 patients with non-dialysis-dependent-CKD (NDD-CKD) have been identified in the study cohort which aims to describe baseline characteristics of an NDD-CKD population with and without anaemia.
This cohort’s size provides information into a highly comorbid population with conditions including hypertension, heart failure, stroke and type 2 diabetes.
In addition, patients with CKD were found to have a high pharmacotherapy burden, with a range of time to initiation of key therapies and increased medication use as CKD stages advance over time.
Anaemia in NDD patients with CKD is frequent and largely undertreated, and rescue therapies including blood transfusions are more often used as first-line treatments than preventative therapies such as intravenous iron or erythropoiesis-stimulating agents.
Further, from the observed baseline characteristics of 125,000 patients with CKD who have hyperkalaemia (HK), AZ found that this cohort face a higher comorbidity burden, which increases as HK severity increases and CKD advances compared to CKD patients without HK.
AZ also observed that the recording of urine-album-creatinine ratio (UACR) in real-world electronic health record (EHR) data is limited, emphasising the need for clinicians to routinely capture and record UACR data as part of routine treatment.
“Rigorous clinical trials are the gold standard for collecting evidence on a treatment’s safety and efficacy, but helping patients live longer and healthier lives doesn’t just involve researching new treatments. We also need an equivalent standard for understanding the experiences of patients in the real world,” said Joris Silon, senior vice president for cardiovascular, renal and metabolism at AZ.
“As we work to create a more coordinated and holistic model of care, our prospective cohort aims to understand the unique challenges of living with CKD and where gaps currently exist by empowering patients to share their experiences and enhancing patient dialogue with HCPs,” he added