Roxadustat for Anemia in Patients With NDD-CKD

Researchers led by Ting Chen, PhD conducted a systematic review and meta-analysis to examine the efficacy and safety of roxadustat for the treatment of anemia in patients with nondialysis-dependent chronic kidney disease (NDD-CKD). Results were reported online in Frontiers in Nutrition [doi:10.3389/fnut.2022.1029432].

The researchers searched for randomized controlled trials of anemia in patients with NDD-CKD testing the efficacy and safety of roxadustat. The primary efficacy end point of interest was the proportion of patients who achieved a hemoglobin response. Secondary efficacy end points included hepcidin, serum iron, serum ferritin, total iron-binding capacity, transferrin saturation (TAST), and low-density lipoprotein. Adverse events were also investigated.

Meta-analyses were performed using Revman 5.4 software. The quality of the evidence was assessed using the Cochrane risk of bias tool. The study was conducted under a pre-established protocol registered with PROSPERO (registration number: CRD42021252331).

The meta-analysis included seven studies representing 4764 patients. Of the 4764 patients, 2730 received roxadustat and 2034 received placebo. The meta-analysis revealed that roxadustat increased hemoglobin levels (weighted mean difference, 1.43; 95% CI, 1.17-1.68; P<.001) and hemoglobin response (relative ratio=8.12; 95% CI, 5.80-11.27; P<.001). Transferrin TAST was significantly increased in the roxadustat groups.

During the treatment period in patients with anemia, there were no statistically significant differences in between the roxadustat and placebo arms in adverse events.

“Roxadustat can improve anemia in NDD-CKD patients by increasing hemoglobin levels and regulating iron metabolism, but does not increase the incidence of adverse events,” the authors said.