I think a lot of people failed to realise that there is no magic bullet to chronic progressive disease like CKD, COPD (emphysema) etc. Anything slowing its progress is a huge achievement. The fact that DMX has shown to improve proteinuria (surrogate marker for renal function and prognosis) in patients with high disease burden/ baseline proteinuria is indicative that it works synergistically with ACE inhibitor. It is this cohort of patients who is at most risk of needing to start dialysis in the short to medium term.
in other words, ACE inhibitor in the form of irbersartan is the standard treatment for proteinuric diabetic CKD. If added an adjunct in the form of DMX and we are able to stretch the time to dialysis by months to years, it is a huge achievement.
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Ann: Positive Top-Line Results in DKD Phase 2 Clinical Study, page-259
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