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Bardoxolone methyl

An antioxidant inflammatory modulator.

Activates the Keap1-Nrf2 pathway, which has an important role in maintaining kidney function and structure.

A derivative of oleanolic acid.

Interacts with cysteine residues on Keap1, allowing Nrf2 translocation to the nucleus and subsequent up regulation of cyto protective genes.

Exerts anti-inflammatory effects by inhibiting the pro-inflammatory nucleus factor kB pathway.

Daily administration for eight weeks increases the estimated GFR in patients with type II diabetes (Pergola P et al).

In a 52 week study this agent significantly improved the estimated GFR among patients receiving standard medical care for chronic kidney disease and type II diabetes.

Most diabetic patients receiving this agent had an estimated GFR increase compared to less than half the patients with placebo {Pergola P et al).

Muscle spasm is the most frequent adverse effect.

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