An experimental drug from pharmtech developer Boehringer Ingelheim may help combat chronic kidney disease (CKD), according to findings from a recent study published in scientific journal The Lancet. Learn how experimental drug BI 690517 works, and what it could mean for CKD patients.*

How BI 690517 works

The kidneys filter toxins, wastes, excess fluid, and excess minerals such as sodium, potassium, and phosphorus out of the blood. When the kidneys don’t function properly, all of these wastes build up in the bloodstream. 

A hormone called aldosterone helps regulate the body’s levels of sodium and potassium, and  stabilize blood pressure. When too much aldosterone is produced, however, the delicate balance is upset, and the result can cause kidney disease to progress faster. 

Unfortunately, two common medications used to treat kidney disease, namely ACE inhibitors and angiotensin receptor blockers (ARBs), can drive up aldosterone levels. Experimental drug BI 690517 was designed to reduce aldosterone production.

“We’ve known for several decades that aldosterone is a major driver of inflammation and fibrosis in the kidney and also in the heart,” says lead study author Dr. Katherine Tuttle, a clinical professor of nephrology at the University of Washington School of Medicine in Seattle. “It has just been very hard to target therapeutically.”

What the researchers did 

For the newest trial, researchers enrolled 586 CKD patients who were already taking either an ACE inhibitor or an ARB. 

• First, participants received either empagliflozin (brand name: Jardiance) or a placebo for 2 months.
• Next, they were randomly assigned to receive either BI 690517 or a placebo for another 3.5 months.

“That gave us the opportunity to test BI 690517 for efficacy at increasing the protection of kidneys and also to reduce the major side effect that had limited the use” of this class of drugs, Tuttle noted.

What they found

The research team found that:

• 50% of the participants who received BI 690517 alone experienced significantly lower levels (a 30% or greater reduction) of the protein albumin in their urine (albumin in urine is a common indicator of CKD) 
• 30% rose to 70% among participants who took both BI 690517 and the drug empagliflozin

While BI 690517 belongs to a class of drugs that can increase the risk for hyperkalemia, empagliflozin can neutralize that effect. Hyperkalemia was, indeed, higher in study participants who received BI 690517, but those cases were not serious.

What it means

While further research is needed to confirm the study’s findings, Tuttle is optimistic. “If we can get it right in terms of awareness and access and detection at a stage where it’s treatable,” she said, “[this drug] might make dialysis almost obsolete.”

*Mundell, Ernie. (2023, December 19). Experimental Drug Could Be Big Advance Against Kidney Disease. HealthDay News. https://www.usnews.com/news/health-news/articles/2023-12-19/experimental-drug-could-be-big-advance-against-kidney-disease#:~ 

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