Review: Roxadustat for CKD-Related Anemia Treatment

Anemia is among the most common complications of chronic kidney disease (CKD). Researchers in China led by Hui Wang, MD, PhD, conducted a systematic review and meta-analysis of data on the treatment of renal anemia with the oral drug, roxadustat. Results of the analysis were reported in the Annals of Palliative Medicine [2021;10(4):4726-4746].

The review included a computerized search of the China Knowledge Network, VIP, Wanfang, China Biomedical, PubMed, Embase, and Cochrane Library databases. The studies of interest were published clinical randomized-controlled trials of roxadustat in the treatment of anemia in kidney disease. Inclusion and exclusion criteria called for the screening and evaluation of included studies. The meta-analysis was conducted using RevMan 5.3 software.

The final analysis included seven randomized controlled trials representing 997 patients with anemia of kidney disease. The meta-analysis demonstrated that compared with treatment with erythropoietin, patients in groups treated with roxadustat had significant increases in hemoglobin (mean difference [MD}, 11.70; 95% confidence interval [CI], 0.41-22.99; P=.04), hemoglobin overall response rate (odds ratio, 1.97; 95% CI, 1.7-3.33; P=.01), serum iron (standardized mean difference [SMD], 0.39; 95% CI, 0.23-0.55; P<.00001), transferrin saturation (MD, 6.09; 95% CI, 5.26-6.82; P<.0001), transferrin (MD, 0.36; 95% CI, 0.28-0.44; P<.00001), total iron binding capacity (SMD, 0.63; 95% CI, 0.47-0.79; P<.00001), and significantly reduced hepcidin (mean difference, –29.04; 95% CI, –51.61 to –6.47; P=.01).

There were no statistically significant differences between the two groups in adverse reactions (OR, 1.06; 95% CI, 0.30-3.74; P=.93).

“Roxadustat can effectively improve the anemia status of patients with CKD without increasing adverse reactions. Due to limitations of the number and quality of the included studies, further verification is required through the multicenter, large sample-sized, and high quality randomized controlled trials in the future.”