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  "documentTitle": "Chinook Therapeutics Inc (KDNY)",
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  "notes": "The slide functions as a critique of clinical trial data integrity, specifically focusing on the inclusion of serum creatinine doubling and the use of inulin as a gold standard.",
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      "text": "But even in this carefully-curated population, AbbVie (and later Chinook) needs to omit certain key data in order to preserve the illusion of drug efficacy, as we will explain infra.",
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      "text": "When researchers used inulin, which one textbook calls “the gold standard” for measurement of GFR, to measure the effect of atrasentan, they found that atrasentan actually made GFR worse.",
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      "text": "On top of this, post-hoc studies from the SONAR trial data suggest that some of the apparent improvement in renal outcomes may be explained by characteristics of the patient population.",
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      "text": "strange dependence of SONAR’s conclusions on widely-questioned metrics: A letter to The Lancet shortly after SONAR’s publication also wondered why serum creatinine doubling was included in the composite renal endpoint, while questioning the paper’s calculation of eGFR.",
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      "text": "Compared to placebo, mean arterial pressure (MAP) and albuminuria decreased significantly, and measured GFR (inulin clearance) tended to decrease with atrasentan. — Source: Journal of Nephrology and Hypertension (2021)",
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