Risk of Red Blood Cell Transfusion Lowered with Roxadustat in Patients with CKD Anemia

Patients requiring red blood cell transfusions may experience reactions leading to allo-sensitization, or rarely transmit infections; thus, treatments that reduce the need for transfusion s are desirable. Researchers, led by Stephen Fishbane, MD, conducted an analysis to determine whether roxadustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, reduced the need for red blood cell transfusions in patients with non–dialysis-dependent (NDD) and dialysis-dependent (DD) chronic kidney disease (CKD) and anemia. Results were reported at the NKF Spring Clinical Meetings online. The report was titled Roxadustat Lowers Risk of RBC Transfusion in Patients with Anemia of CKD.

The analysis included data from six completed randomized phase 3 studies with up to 4-year duration. The studies included patients with stage 3-5 CKD. The studies compared roxadustat with placebo among patients with NDD CKD and roxadustat with epoetin alfa among patients with DD CKD. Individual studies assessed the risk of first red blood cell transfusion; the risk was also assessed within pooled NDD and DD populations.

A total of 4277 patients with NDD CKD were included in the analysis: 2391 in the roxadustat arm and 1886 in the placebo arm. At baseline, mean hemoglobin was 9.10 g/dL in the roxadustat arm and 9.10 g/dL in the placebo arm. In the DD-CKD cohort (n=3857; 1929 roxadustat/1928 epoetin alfa), mean baseline hemoglobin was 9.63 g/dL  in the roxadustat arm and 9.67 in the epoetin alfa arm. In the NDD-CKD cohort, roxadustat reduced the risk of red blood cell transfusion by 74% versus placebo; in the DD-CKD cohort, roxadustat reduced the risk of red blood cell transfusion by 18% versus epoetin alfa.

In conclusion, the researchers said, “Roxadustat markedly and significantly reduced the risk of red blood cell transfusion during anemia treatment compared with placebo in NDD CKD and, versus epoetin alfa in DD CKD in the pooled patient populations.”

Source: Fishbane S, Provenzano R, Rastoki A, et al. Roxadustat lowers risk of RBC transfusion in patients with anemia of CKD. Abstract of a presentation at the National Kidney Foundation 2020 Spring Clinical Meetings; abstract #186.