Therapeutic Focus

Chronic Kidney Disease associated Pruritus (CKD-aP)

The Need for a Breakthrough Therapy for CKD-aP

There has been very little innovation in pharmaceuticals that specifically treat patients’ pruritus or itch over the last 50 years. The mainstays for treating itch today are still corticosteroids and antihistamines. The first corticosteroids and antihistamines were discovered and launched in the 1940s. There have been modest improvements in these drug classes in the subsequent years, but the products utilized today are very similar in action and side effects as those used over 50 years ago.

Despite the fact that there are lots of products used to treat pruritus, most patients that suffer from CKD-aP still experience inadequate itch relief as well as significant side effects with their medications. One the significant problems with many itch medicines today is the manner in which they work. CKD-aP is not caused by the release of histamine – a common cause of itching; therefore, the use of one of the main classes of antipruritic drugs, antihistamines, is generally ineffective. Also, the long term use of the other main class of drugs used for itch, corticosteroids, is problematic due to their side-effect profile.

The patients who live with chronic kidney disease associated pruritus or itch and the clinicians who treat it are desperately in need of a new novel antipruritic that will work differently than traditional anti-pruritics to provide itch relief without the significant side effects one finds in today’s medicines.

Breakthrough Therapy for CKD-aP

Cara Therapeutics is developing a breakthrough therapy to change the way chronic kidney disease associated pruritus (itch) is managed. Cara is developing a completely new class of medicine called kappa opioid receptor agonists. Kappa agonists target a completely different receptor in the body, the kappa receptor, to treat itch in a new way. Our lead pipeline product, KORSUVA (difelikefalin) is a peripherally acting kappa agonist. To date, KORSUVA IV has shown in Phase 3 clinical trials promising improvements in itch relief in CKD-aP patients on hemodialysis and we are studying KORSUVA Tablets in a Phase 2 trial for non-hemodialysis patients with CKD-aP.