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  "documentTitle": "Chinook Therapeutics Inc (KDNY)",
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  "authorName": "Carson C. Block",
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  "notes": "The slide uses data from the RADAR trial to challenge the validity of UACR as a reliable surrogate endpoint for kidney function.",
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      "text": "Instead, the results we see are much more consistent with a confounding effect of atrasentan on the surrogate biomarkers used by the trial, which would not reflect any real renal benefit.",
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      "text": "It is known that UACR is a correlate, not a direct indicator, of disease severity. But if UACR returns to normal immediately after drug cessation, we see that is has not been a reliable correlate.",
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      "text": "Figure from both the RADAR and SONAR analyses show that important surrogate biomarkers converge between atrasentan and placebo groups very shortly after treatment cessation. This is not the result we should expect if atrasentan is slowing renal decline.",
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      "text": "SONAR was designed on the basis of the observation that risk of progressive kidney disease is correlated to albuminuria... There are caveats to the usefulness of this design. Most importantly, the biologic response is most likely to predict a clinical treatment response if the biologic response lies on the causal pathway. History tells us that our assumptions that associations between biologic responses and clinical response, no matter how consistent and strong, are causal, are frequently incorrect. — JASN Journal",
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      "text": "All Differences Between Groups Disappear After Trial",
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