Dmytro D Ivanov
Shupky National Medical Academy, Ukraine
Title: Development of new drugs or OMICS-diagnostics of treatment failure
Biography
Biography: Dmytro D Ivanov
Abstract
The aim - identifying the biological trends in formation of treatment efficacy in various kidney diseases. 20-year observation of treatment results in 4 groups: urinary tract infection - UTI (5643) patients, glomerulonephritis, nephrotic syndrome - NS (464), lupus nephritis - LN (68), and month from the treatment beginning (1) and 1 year follow-up (2). For each nosology isolated characteristics that determine the effectiveness of therapy in steps 1 and 2 were adjusted. For UTI – microbe and antibiotics sensitivity was 87 ± 4% (1), recovering - 96 ± 2% (2),total - 82% (RR 1.08 0.98-1.17 95%). NS steroid sensitivity was 49 ± 7% (1) and the remission79% ± 3 (2), total - 72% (RR 1,03, 95% 0,97-1,09). In LN - remission was observed in 44 ± 4% (1) and 68% ± 3 (2), in total 63% (RR 1,28, 95% of 1.11-1.41). In CKD - reduction of albuminuria ascertained at 69 ± 2% (1) and GFR preservation- 87 ± 2% (2), a total of 83% (RR 1,08, 95% 0.98-1.17). As a result, depending on the nosology, 3 months efficacy was 96-57% (71 ± 7), 1 year - 91-69% (75 ± 3). The average of efficiency therapy was 74.8%. Thus, the response to therapy in 1 year follow-up was the dominant sign in a ratio of 3:1 to non response subjects (Mendelian inheritance). Conclusions. Modern therapy provides cure / remission in 75% of nephrology patients, which corresponds to the dominant hence inheritance trait of population. Failure of treatment in 25% of patients is not due to lack of efficiency, population- recessive traits. Seems that marginal efficiency of existing treatment facilities in general has already been exhausted. Development of new drugs are likely to be ineffective without seeking genetic mechanisms/markers leading to the development of renal process itself, rather than improve the sensitivity to the drug. In our opinion, OMICS-diagnostics detect a marker (s), allowing understanding why a given individual has developed kidney disease, will be crucial in the treatment of nephrology patients.