TY  - JOUR
A1  - de Zeeuw, Dick
A1  - Akizawa, Tadao
A1  - Agarwal, Rajiv
A1  - Audhya, Paul
A1  - Bakris, George L.
A1  - Chin, Melanie
A1  - Krauth, Melissa
A1  - Lambers Heerspink, Hiddo J.
A1  - Meyer, Colin J.
A1  - McMurray, John J.
A1  - Parving, Hans-Henrik
A1  - Pergola, Pablo E.
A1  - Remuzzi, Giuseppe
A1  - Toto, Robert D.
A1  - Vaziri, Nosratola D.
A1  - Wanner, Christoph
A1  - Warnock, David G.
A1  - Wittes, Janet
A1  - Chertow, Glenn M.
T1  - Rationale and Trial Design of Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes: The Occurrence of Renal Events (BEACON)
JF  - American Journal of Nephrology
N2  - Background: Chronic kidney disease (CKD) associated with type 2 diabetes mellitus constitutes a global epidemic complicated by considerable renal and cardiovascular morbidity and mortality, despite the provision of inhibitors of the renin-angiotensin-aldosterone system (RAAS). Bardoxolone methyl, a synthetic triterpenoid that reduces oxidative stress and inflammation through Nrf2 activation and inhibition of NF-κB was previously shown to increase estimated glomerular filtration rate (eGFR) in patients with CKD associated with type 2 diabetes mellitus. To date, no antioxidant or anti-inflammatory therapy has proved successful at slowing the progression of CKD. Methods: Herein, we describe the design of Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes: the Occurrence of Renal Events (BEACON) trial, a multinational, multicenter, double-blind, randomized, placebo-controlled Phase 3 trial designed to determine whether long-term administration of bardoxolone methyl (on a background of standard therapy, including RAAS inhibitors) safely reduces renal and cardiac morbidity and mortality. Results: The primary composite endpoint is time-to-first occurrence of either end-stage renal disease or cardiovascular death. Secondary endpoints include the change in eGFR and time to occurrence of cardiovascular events. Conclusion: BEACON will be the first event-driven trial to evaluate the effect of an oral antioxidant and anti-inflammatory drug in advanced CKD.
KW  - clinical trial
KW  - diabetes mellitus
KW  - glomerular filtration rate
KW  - trial design
KW  - bardoxolone methyl
KW  - Nrf2
KW  - end-stage renal disease
KW  - cardiovascular death
KW  - chronic kidney disease
Y1  - 2013
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-196832
SN  - 0250-8095
SN  - 1421-9670
N1  - This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
VL  - 37
IS  - 3
ER  - 
TY  - JOUR
A1  - Weidemann, Frank
A1  - Sanchez-Nino, Maria D.
A1  - Politei, Juan
A1  - Oliveira, João-Paulo
A1  - Wanner, Christoph
A1  - Warnock, David G.
A1  - Oritz, Alberto
T1  - Fibrosis: a key feature of Fabry disease with potential therapeutic implications
JF  - Orphanet Journal of Rare Diseases
N2  - Fabry disease is a rare X-linked hereditary disease caused by mutations in the AGAL gene encoding the lysosomal enzyme alpha-galactosidase A. Enzyme replacement therapy (ERT) is the current cornerstone of Fabry disease management. Involvement of kidney, heart and the central nervous system shortens life span, and fibrosis of these organs is a hallmark of the disease. Fibrosis was initially thought to result from tissue ischemia secondary to endothelial accumulation of glycosphingolipids in the microvasculature. However, despite ready clearance of endothelial deposits, ERT is less effective in patients who have already developed fibrosis. Several potential explanations of this clinical observation may impact on the future management of Fabry disease. Alternative molecular pathways linking glycosphingolipids and fibrosis may be operative; tissue injury may recruit secondary molecular mediators of fibrosis that are unresponsive to ERT, or fibrosis may represent irreversible tissue injury that limits the therapeutic response to ERT. We provide an overview of Fabry disease, with a focus on the assessment of fibrosis, the clinical consequences of fibrosis, and recent advances in understanding the cellular and molecular mechanisms of fibrosis that may suggest novel therapeutic approaches to Fabry disease.
KW  - Fabry
KW  - fibrosis
KW  - podocyte
KW  - Lyso-Gb3
KW  - kidney
KW  - enzyme replacement therapy
KW  - alpha-galactosidase-A
KW  - focal semental glomerulosclerosis
KW  - cardiovascular magnetic-resonance
KW  - left-ventricular hypertrophy
KW  - biopsy findings
KW  - agalsidase-beta
KW  - natural-history data
KW  - cardiac energy metabolism
KW  - randomized controlled trial
Y1  - 2013
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-124773
SN  - 1750-1172
VL  - 8
IS  - 116
ER  -