Avosentan is a novel endothelin antagonist, which can be added to the standard treatment for nephropathy. However, a mulicenter, randomized trial showed that though the new therapy reduced albuminuria in patients with overt diabetic nephropathy, it also raised their risk of cardiovascular problems. The avosentan study was planned to be a 42-month trial, but was halted after a median follow-up of only four months. When the trial was stopped, the patients who received avosentan were more likely to have fluid overload and congestive heart failure than those who received a placebo. The research will be reported in the March issue of the Journal of the American Society of Nephrology.
According to one of the researchers, despite the benefits of avosentan, the dosages used in the study can’t be used with patients with Type 2 diabetes and stage 3 or 4 chronic kidney disease. However, other medical experts believe that the drug may be used with some patients. The research does not make clear "whether lower doses of avosentan could be effective in patients with overt diabetic nephropathy while avoiding serious side effects."