Anna Sundgren, Renal Disease Strategy Leader, Global Medicines Development at AstraZeneca, talks about what’s on the horizon for chronic kidney disease (CKD) patients, and the physicians that treat them — who’ve seen little innovation in treatment advancements in over 30 years.
Dr. Anna Sundgren is the Renal Disease Strategy Leader, Global Medicines Development at AstraZeneca. Dr. Sundgren has been involved in research and pharmaceutical development for more than 20 years, since being awarded a Ph.D. in neurochemistry and neurotoxicology from Stockholm University in Sweden. After spending time as a research fellow and preclinical scientist at Northwestern University’s Feinberg School of Medicine, Dr. Sundgren joined AstraZeneca in 2001. During her career at AstraZeneca, Dr. Sundgren’s roles have also included Senior Research Scientist, Discovery Project Leader and Global Project Manager, which included defining the right targets to pursue in order to discover the drugs to be progressed into medicines and leading project teams; Global Medical Affairs Leader, working across several disease areas, including inflammation, metabolic disease, pain and cognitive disorders; Group Clinical Director within Global Medicines Development, leading a team of scientists and physicians in the area of cardiovascular, renal and metabolism; and Therapy Area Clinical Director of Cardiovascular, Renal and Metabolism to support renal medicines under investigation to address chronic kidney disease and its complications.
Neal Howard: Hello I’m your host Neal Howard here on Health Professional Radio, thank you so much for joining us our guest is Anna Sundgren, she’s Renal Disease Strategy Leader and Global Medicines Development that AstraZeneca and she’s joining us on Health Professional Radio today to discuss what’s on the horizon for chronic kidney disease patients or CKD patients and the physicians that take care of them. We’ve seen very little innovation apparently in the last three decades or so and Dr. Sundgren is going to give us an insight into what we can expect in the coming years. Thanks for joining us on the program today Dr. Sundgren.
Dr. Anna Sundgren: Thank you so much for having me.
Neal: Renal disease strategy leader at AstraZeneca, it’s quite a mouthful and I’m sure you’ve got quite a responsibility there. Give us a bit of your background and let’s talk about what you do there at AstraZeneca.
Dr Sundgren: It is a mouthful Neal, yeah. I’ve been working with AstraZeneca for a very long time actually and I’ve always been very interested in renal disease. I’m a PhD by training and my mom actually passed away while on dialysis and it’s been driving my purpose in this for a long time. So for five years I’ve been really committed to making sure that whatever we do with our drugs can also benefit renal patients which is an area that has seen very little innovation in the past 30 years, I would say.
Neal: How many people would you say are affected by renal disease, chronic kidney disease on a worldwide basis?
Dr Sundgren: Yeah, it’s about 1 in 10 which is remarkable actually when you think about it. It’s a disease that’s not really well known, it’s insidious in its nature and it’s really sort of a silent killer because you’re not really aware that you are sick until you really think and one in ten is a big number.
Neal: What types of symptoms are we talking about that or so I guess subtle or not alarming that we could be sick and not know it?
Dr Sundgren: That’s a very good question. So the kidney is a vital organ for us, it clears toxins out of the body and clears water out of the body and when you’re born, you’re born with a certain number of units which are called filtering units or nephrons and you don’t get any new ones. You’re born with the ones you’re going to get essentially and over time, you lose them and it’s a normal process so over time with age, you lose these filtering units but when you are seeing accelerated disease drivers and this could be high sugar or high blood pressure or ongoing inflammation. These filtering units, you can lose them faster over time and it’s not apparent to you as a person that your filtering capacity goes down until it’s really bad and then you start seeing complications because of your inability to clear yourself from water and toxins and ions.
Neal: Is there a method by which we can monitor our kidney functions, say in our teens, then again a few decades later to kind of keep a watch on our kidney function? Or there’s no preventing it? Just monitoring, to give us an opportunity?
Dr Sundgren: Yeah, no, absolutely you can monitor it. So there’s a primary trajectory to measure protein in a more learning capacity with a function which is called glomerular filtration rate which is calculated on your BMI, your body weight and a marker called creatinine. But what’s interesting is that but normally in clinical practice, we don’t really do it very well and if you are a person with a high risk such as you’re having diabetes or hypertension or even if you have kidney disease in your family, it’s really important that you do monitor it and not everybody does that.So therefore when the kidney function dramatically has gone down over several years, that’s when you’re starting to see these complications and then you approach your physician and then at that time, it’s late and your kidney function is very difficult to restore.
Neal: Having been involved for many, many years in renal functions – why in your opinion do you think that the medical field hasn’t accelerated its I guess the sense of urgency? I mean one in 10 worldwide, that must be at least comparable here in the United States. Why do you think it is that the medical community isn’t jumping on board with more tenacity as far as kidney function is concerned?
Dr Sundgren: Yeah, that’s a really again a very good question. And I think the first reason I think there is that when we do clinical trials for any type of disease, when you select patients for those trials, you want to make sure that you select patients that are the right ones. And people with declined kidney functions are often excluded from such trials because they are frail and we don’t want to induce any problems for them with exploratory drugs and so very often these patients are sort of excluded which means that very very few trials are actually done in renal disease patients and that is one of the reasons so we wouldn’t have found serendipitously by just sort of finding it by coincidence. We would have found new drugs because we’ve excluded the patients in our trials and then when it comes to actual sort of dedicated drug development, you really have to focus on these patients in order to find the scientific mechanisms that make sense and unfortunately there’s been a few companies that have done that and so we are very proud in AstraZeneca to come from a heritage where we have done a lot of cardiovascular development, we have a big portfolio in diabetes and we’re also very interested in inflammation and have worked in inflammation and respiratory for a long time. And since those three are the primary drivers together, the primary drivers for renal disease, it made a lot of sense for us to put a stake in the ground and really move into development for renal disease patients. And I’m very proud that this year, we are going to be able to launch two new medications globally, not in the U.S. but two new medications – one in the U.S. and one in another country – that are actually targeting these patients and it’s actually a very big step for this community where it’s been very quiet for several years.
Neal: What would you say is on the horizon? I mean one in ten cases, do you think that we can bring that down to maybe one in eight over the next 20 years?
Dr Sundgren: That is absolutely my vision. I’m hoping that we can see a world ahead of us, not too far away, where people living with CKD are able to live much longer and really, when they get the diagnosis, it’s not a death sentence so we want to really be able to help manage the complications that are life-threatening and also stop the progression. And so a visionary future for us would be that there would be less need for dialysis centers and also that there would be a better supply-demand match for transplants because if we can halt these people progressing in their disease and also manage how they die essentially, because there’s a lot of people coming to cardiovascular deaths in this area. And if we can manage that, both complications and disease progression, then we do believe that we can move from CKD being a death sentence for you to something that’s much more positive for just over a few years.
Neal: Where can we go online and get some more information as listeners about AstraZeneca and the developments that you’re working on to combat CKD?
Dr Sundgren: So the best place is to go to our website, it’s astrazeneca.com and we have a very interesting view there of our renal portfolio that you can have a look at.
Neal: Dr. Sundgren thank you so much for joining us here on Health Professional Radio.
Dr Sundgren: Thank you Neal, it was a delight to talk to you.
Neal: With you as well. You’ve been listening to Health Professional Radio, I’m your host Neal Howard in conversation with Dr. Anna Sundgren, Renal Disease Strategy Leader and Global Medicines Development that AstraZeneca. Transcripts and audio of this program are available at hpr.fm and healthprofessionalradio.com.au can also subscribe to this podcast on iTunes, listen in and download at SoundCloud and be sure and visit our Affiliate Page at hpr.fm and healthprofessionalradio.com.au