Scientific insights:CKD

The best kidney drugs weren’t built for kidneys.

Our AI, VibeOne, recently generated a landscaped & analyzed >100 drug programs in Chronic Kidney Disease (CKD). CKD is a burgeoning area of interest for pharma – it’s a condition affecting 850 million people globally. Kidney-related indications broadly are a hot topic amongst Vibe Bio’s pharma partners.

A few observations jumped out:
1. Small molecules dominate.
Despite the industry narrative that biologics are displacing traditional chemistry (and the recent trend of AI-driven antibody design), small molecules dominate in this space.

📈 >60% of the active CKD pipeline are small molecules
🧪 CKD-focused small molecules have the highest approval rate of any modality

The contrast with antibodies is stark:
🏥 12 in clinical development
🦴 Only 1 approved (denosumab for osteoporosis in patients w/ CKD… but doesn’t improve kidney functionality)
💊 75% lingering in trials

Gene therapy? One program. Cell therapy? Four.

In a complex, chronic, multi-organ disease where you’d expect newer modalities to shine, but here, traditional chemistry continues to dominate.

2. Repurposing beats de novo development.
The most impactful disease-modifying therapies approved in the last decade (SGLT2 inhibitors Jardiance, Farxiga), finerenone (Kerendia), GLP1) originated from diabetes or cardiology indications first. It’s interesting that CKD often followed success in an adjacent, better-understood disease.

Perhaps the next blockbuster kidney drug may be in a Phase III cardiovascular trial? And it’s likely a small molecule.

That said, I think there’s a big opportunity for novel, kidney-first programs and modalities that offer true patient benefit.

Want to see the full assessment of this CKD asset? Reach out and we’ll send it to you!

Photo by julien Tromeur on Unsplash