Design and Rationale of the Phase 2 Baricitinib Study in Apolipoprotein L1–Mediated Kidney Disease (JUSTICE)

• DOI: 10.1016/j.ekir.2024.06.033
• Publication Date: 2024-06-28T00:52:15Z
• Authors: Opeyemi A. Olabisi; Nadine J. Barrett; Anika Lucas; Maurice Smith; Kenisha Bethea; Karen Soldano; Stephanie Croall; Azita Sadeghpour; Hrishikesh Chakra...; Myles Wolf

Individuals of recent West African ancestry develop focal segmental glomerulosclerosis (FSGS) and hypertension-attributed end-stage kidney disease (HTN-ESKD) at 4 times the rate White Americans. Two protein-coding variants Apolipoprotein L1 (APOL1) gene, G1 G2, explain 50% to 70% excess risk HTN-ESKD FSGS among this group. Increased expression G2 in kidney, mediated by Janus kinase/signal transducer activator transcription (JAK-STAT) signaling, drive pathogenesis these diseases. Baricitinib is an orally active inhibitor JAK1/2 that blocks APOL1 synthesis. The kinase-STAT Inhibition Reduce APOL1-Associated Kidney Disease (JUSTICE) trial evaluating antiproteinuric efficacy safety baricitinib patients with APOL1-associated HTN-attributed chronic (HTN-CKD).