The FDA is yet to approve a therapy specifically for FSGS. That could change soon. Travere filed for FDA approval of Filspari in the indication this March. Amicus’ willingness to bet on DMX-200 despite the potential of a rival that is near approval reflects a belief that there is room for multiple approaches in FSGS.Jeffrey Castelli, chief development officer at Amicus, said on an earnings call Thursday that DMX-200 “is specifically targeting the inflammatory signaling in the damaged kidney.” Other molecules, in contrast, are focused on hemodynamics. Some patients will respond better to one drug than the other, Castelli said, and physicians will try to figure out which is the right approach for each individual. “With DMX-200, there are ways you can look at how much the inflammatory component is driving things. Those are going to be the patients we're going to see respond best in the trials, and those are going to be the patients that I think doctors will want to focus on,” Castelli said.
Amicus believes the mechanism of DMX-200 will “really maximize the ability to shut down the monocyte inflammation,” Castelli said. The downstream effects will also allow “monocytes to continue their job elsewhere ... so they can still fight infections as they should outside of the kidney.”
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