& you will see warning signs abounded long before this aliskren debacle
they knew , they knew
they knew , they knew
Google multiple drugs working on the RAAS
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Long time ago, I stopped expecting that our management's decisions take science and data into consideration; they think it's an old-fashioned way. No big surprise RE: this outcome.
ure idiots...all the prelim biomarkers pointed towards beneficial outcomes. Just cause your shitty reps and dont know you're products, doesnt mean u should be the victim and think our mngmnt team doesnt care about us. Like they'd invest billions in tkt and let it fall, moron. The dual RAAS concerns were with ACEi & ARB in the past, absolutely no preliminary biomarker data that supported is with TKT. That is science and how it rolls out sometimes...we dont need this many reps per territory regardless, most of u are garbage..
And I bet you've been promoting what Tekturna could do based on the bio markers and the NEJM article.
Karma! Novartis is getting exactly what it deserves!
negative...its in direct response to the claims of no foresight. You can't blaim them, most of the people are blaiming NVS, you can't in this case..
Renin-Angiotensin-Aldosterone System Blockade Effects on the Kidney in the Elderly: Benefits and Limitations
Faruk Turgut,
Rasheed A. Balogun,
Emaad M. Abdel-Rahman
JULY 2010 CJASN
Elderly patients present special concerns regarding the benefits versus risks of using RAAS blockers. Plasma renin activity declines with age, which has been attributed to the effect of age-associated nephrosclerosis. Plasma aldosterone is also reduced with age, resulting in a greater risk for hyperkalemia in older individuals, especially when coupled with the age-associated decline in GFR. Moreover, the elderly have a higher frequency of concurrent conditions and are on many medications, which may further increase the risk for adverse effects of RAAS blocking agents. Unfortunately, there is a paucity of literature that is specifically aimed at studying elderly using the RAAS blockers.
Elderly individuals have unique characteristics that make them more liable to experience renal adverse effects with the use of agents that block the RAAS. There is a greater potential risk for further deterioration of renal function in the elderly, especially in patients with advanced CKD (Table 1). In fact, a recent study by Ahmed et al. (20) that evaluated the impact of discontinuing RAAS blockers in elderly patients (mean age 73.3 years) with stages 4 and 5 CKD demonstrated an improvement of estimated GFR from 16.38 to 26.60 ml/min by 12 months after stopping these agents, suggesting that RAAS blockers contribute to further decline in GFR in elderly patients with advanced CKD.
Aliskiren has some theoretical advantages that could contribute to its end-organ protection; however, there is as yet no evidence to justify replacing an ACEI or an ARB with aliskiren for renal outcomes in elderly patients.
Faruk Turgut,
Rasheed A. Balogun,
Emaad M. Abdel-Rahman
JULY 2010 CJASN
Elderly patients present special concerns regarding the benefits versus risks of using RAAS blockers. Plasma renin activity declines with age, which has been attributed to the effect of age-associated nephrosclerosis. Plasma aldosterone is also reduced with age, resulting in a greater risk for hyperkalemia in older individuals, especially when coupled with the age-associated decline in GFR. Moreover, the elderly have a higher frequency of concurrent conditions and are on many medications, which may further increase the risk for adverse effects of RAAS blocking agents. Unfortunately, there is a paucity of literature that is specifically aimed at studying elderly using the RAAS blockers.
Elderly individuals have unique characteristics that make them more liable to experience renal adverse effects with the use of agents that block the RAAS. There is a greater potential risk for further deterioration of renal function in the elderly, especially in patients with advanced CKD (Table 1). In fact, a recent study by Ahmed et al. (20) that evaluated the impact of discontinuing RAAS blockers in elderly patients (mean age 73.3 years) with stages 4 and 5 CKD demonstrated an improvement of estimated GFR from 16.38 to 26.60 ml/min by 12 months after stopping these agents, suggesting that RAAS blockers contribute to further decline in GFR in elderly patients with advanced CKD.
Aliskiren has some theoretical advantages that could contribute to its end-organ protection; however, there is as yet no evidence to justify replacing an ACEI or an ARB with aliskiren for renal outcomes in elderly patients.
