Obesity, diabetes, hypertension and dyslipidemia are increasing at alarming rates, alongside parallel increases in the incidence and prevalence of many associated cardiometabolic complications such as stroke, heart failure, renal and liver disease. With varying physician specialties responsible for each disease state, this presents additional complexities when determining optimal holistic treatment choices. Conditions such as non-alcoholic steatohepatitis (NASH) currently offer no approved therapy option often resulting in physicians aiming to treat the underlying cause of disease via comorbidities. Conversely, diabetes has seen a proliferation of therapeutic options enter the market resulting in a myriad of treatment pathways or, in some patient cases, treatment inertia.

The metabolic space currently has varying challenges from no approved therapies (non-alcoholic steatohepatitis (NASH)) to a re-engaged market (Obesity) to a well-established market (Type 2 Diabetes). Therapies are in development with interlinked benefits such as significant weight-loss alongside HbA1c reduction, with aims to treat a patient more holistically and potentially target multiple diseases in one administration. Other novel therapies address fibrotic status and could potentially complement weight-loss and anti-diabetic approaches. With such a heterogeneous patient population with personalised needs, this also translates a need for a multi-specialty approach working together.

In the cardiovascular space, an area of focus currently is heart failure (HF). A market that was previously dominated with generics has seen a growth in recently launched therapies that ultimately aim to reduce hospitalisations and CV-related mortality. The SGLT2 drug class, familiar with many physicians for its other therapeutic indications is likely to see a large uptake with recent approvals for treatment in patients across all HF phenotypes.

In the last few years the area of nephrology has become more and more dynamic. Much as we have seen in heart failure, prescribed therapies used for other conditions have proved successful in gaining a specific chronic kidney disease (CKD) label and new drugs have been launched specifically to treat CKD, providing physicians more varied therapeutic options than simply managing the underlying causes and comorbidities of the disease.

We have also seen a big shift to drug development in rare nephrology, more specifically the complement-mediated kidney diseases, which occur due to an over active immune system. Such diseases include C3 glomerulopathy (C3G), IgA nephropathy (IgAN), atypical hemolytic uremic syndrome (aHUS) and membranous nephropathy (MN). These areas have seen one or two drug launches, but there remains a huge level of unmet need and misdiagnoses are common.
As the nephrology space evolves, so do the Disease Specific Programmes.

Our vision is to provide a comprehensive understanding of the current landscape, unmet need and challenges faced in the management of all these Cardio-Renal-Metabolic (CVRM) conditions. This is being met by the continual launch of DSPs in new areas such as C3G, aHUS and IgAN with updates to previously conducted DSPs in areas such as Heart Failure, Diabetes, NASH and CKD.