Final NICE guidance recommending new drugs for CKD

The National Institute for Health and Care Excellence (NICE) have issued final guidance recommending the use of two new treatments: empagliflozin and targeted-release budesonide.

New treatment: empagliflozin

Empagliflozin (Jardiance®) is licensed as an option for treating adults with chronic kidney disease (CKD). It is an SLGT2 inhibitor, the second medicine of this type to be recommended by NICE as a treatment for people with CKD. Research shows that SGLT2 inhibitors can slow down the progression of kidney disease and also reduce the risk of cardiovascular problems.

It is recommended as an add-on treatment to the highest tolerated dose of converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), where these are suitable, for people with type 2 diabetes or a urine albumin-to-creatinine ratio of 22.6 mg/mmol or more and an estimated glomerular filtration rate within a specific range.

You can read clinical practice guidelines and patient information resources about SGLT-2 inhibitors in adults with kidney disease on the UK Kidney Association website.

Kidney Care UK contributed to the NICE appraisal of this drug, highlighting the challenges of living with kidney disease and the difference a drug that can slow down progress of the disease and potentially delay the need for dialysis can make to people.

New treatment: targeted-release budesonide

Targeted-release budesonide is the first licensed treatment for primary immunoglobulin A nephropathy (IgAN) and is recommended as an option for treatment where there is risk of rapid disease progression in adults with a urine protein-to-creatinine ratio of 1.5g/g or more.

Guy Hill, a member of Kidney Care UK’s Patient Advisory Group, was a patient expert during the NICE appraisal. He participated in NICE committee meetings, making sure that the committee understood how the condition affects people and the importance of preventing disease progression.

Targeted-release budesonide is recommended only if it is an add-on to optimised standard care including the highest tolerated licensed dose of angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), unless those treatments are not recommended for an individual.

Availability of new treatments for patients

Now that the final NICE guidance has been published, the NHS must make sure a new treatment is available within 3 months This means that, if a patient has the disease or condition specified in the guidance and their doctor thinks that the technology is the right treatment, it should be available for use, in line with NICE's recommendations.

We recommend you speak to your clinician if you have any questions about these treatments.