Private Equity Deal Rush Shows Lenders Are Losing Their Star Billing
As one of the world's largest sovereign wealth funds warned this week that private equity is ' very troubled ' right now, a spate of recent buyout deals in Europe and the US points to a possible route out of the mire: The deep shift in how much debt this industry uses to fund its takeovers.
KKR & Co. has been busily dealmaking despite the gloom around President Donald Trump's tariff upheavals, snapping up a couple of Swedish health specialists in the process. Fellow private equity firm Thoma Bravo, meanwhile, has pulled together one of the year's biggest buyouts with the $10.6 billion purchase of Boeing Co.'s Jeppesen navigation unit and other assets.
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'This is a true barrier to care,' Jaar wrote. 'Clinicians are worried about the potential complications associated with hyperkalemia, such as arrhythmias and even death.' Jaar noted that the FIDELITY analysis has several strengths, including its large sample size of patients with varying stages of CKD and degrees of proteinuria, and a risk score model that incorporated readily available clinical variables. He added that it reports a stepwise increase in hyperkalemia risk across risk score tertiles in both placebo and finerenone groups, even though all patients were already on a maximally tolerated RAAS blockade agent. However, he questioned the study's generalizability, given that it excluded patients if their serum potassium was > 4.8 mmol/L. 'This risk model in predicting hyperkalemia needs to be validated in other populations where diet may be different,' Jaar wrote. 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This would allow more nuanced approaches for following up patients taking drugs with established hyperkalemia risk. 'If the patient cannot come after a month, can I make a clinical judgment and say, 'Okay, if you came back after 3 months, your risk of hyperkalemia is low enough that I'm willing to take that risk,'' he said. 'Or if the risk of hyperkalemia is high, you can tell the patient who can't come back in 30 days, 'I don't think I want to prescribe this drug for you'.' The work on the risk model was supported by Bayer, which also funded the FIDELIO-DKD and FIGARO-DKD studies and pooled analysis. The study's authors included Bayer employees. Other financial relationships of the authors included research support, consulting and other fees from companies including: Abbott Vascular, Amgen, Astellas, AstraZeneca, Bayer, BioVentrix, Boehringer Ingelheim, Brahms, Brainstorm Medical, Cardiac Dimensions, Cardior, Cereno Scientific, CSL Vifor, CVRx, Edwards, Eli Lilly, G3 Pharmaceuticals, Gilead, GSK, Impulse Dynamics, Janssen, KBP Biosciences, Mundipharma, Novartis, Novo Nordisk, Occlutech, PhaseBio, Proton Intel, Respicardia, Sanofi, Sarfez, scPharmaceuticals, Servier, SQ Innovation, Tricida, Vectorious, Vifor International, and V-Wave. Agarwal had received support from Bayer. He also had received consulting fees and other support from Boehringer Ingelheim, Novartis, Akebia, Intercept Pharma, Alnylam, and Vertex. Jaar reported no relevant financial disclosures.
