VIDEO: 'Standardization' of management approaches important unmet need in glomerular disease

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From a research standpoint, I think we're on the track, right? We're looking at newer approaches to treatment that are more sophisticated and more nuanced. If I think about unmet need, the unmet need to me is a little bit clinical. Are physicians who are not experts in glomerular disease or even nephrologists, are they identifying these patients, right? Because if they don't come to the attention of nephrologists or in particular people who think about glomerular disease all the time, then, you know, we're losing really catching diseases early in their course.

So our generalist recognizing the presence of hematuria and proteinuria in either hospitalized patients or patients in the clinic and saying, "Wait a minute, this requires a referrals, not a lab error." So that's, I think, really important for us to catch these processes early before there's been a lot of damage to the kidneys.

I think when you look at management, I think standardization of our approaches is really key. This is one thing we've tried to do at our center, which is, instead of having sort of one or two, you know, glomerular disease gurus who are, you know, the go-to person for everything, we've sort of separated that work among a number of different people but tried through a bunch of educational seminars, and actually we've developed a glomerular disease sort of almost like a tumor board approach to management to sort of standardize how we're doing things at our center.

So it's been very cool because, you know, similar to what the oncologists and others are doing, we're getting together as a multidisciplinary group and saying, "What is our approach to this condition? How are we gonna treat ANCA disease? What are the latest guidelines suggesting?" When I think about where we're going, it's probably, as I said earlier, I think it's a reduction in sort of old fashioned approaches, like steroids. They still have a role. My guess is they're gonna have less of a role in the next, you know, decade or so, as we find other treatments that allow us to lower that dosing. It's gonna be a high bar to find agents that we say, "Okay, completely replace steroids." It's gonna take a series of studies, unfortunately. And yeah, no, I think those are the unmet needs.

I think therapeutically uncondition, that's really critical for us, is IgA nephropathy. It's very common, arguably the most common form of glomerular disease in the world, and partially because of its slow onset of injury, we've been a little bit behind as far as finding therapies for it, and this is one, I think, enthusiastic about what's coming. There's a lot of different types of investigations looking at different types of approaches to treating this. And I think that very likely we'll see in the next, let's say, decade, a number of new approaches that give us a little bit more sophisticated approach to this condition.