Roxadustat for the Management of Patients With CKD-Related Anemia

Patients with early chronic kidney disease (CKD) frequently develop anemia. Current guidelines for the management of anemia of CKD call for oral or intravenous iron supplements, erythropoiesis-stimulating agents, and, when the benefits of transfusion outweigh the risks,  transfusions of red blood cells.

According to Francesco Locatelli, MD, and colleagues in Italy, anemia in patients with CKD is underdiagnosed and undertreated. There are challenges associated with the current standard of care, leading to the exploration of new treatment approaches for this patient population.

Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) are a new class of orally administered drugs used to treat anemia in patients with CKD. Small molecule HIF-PHIs have a novel mechanism of action that activates the hypoxia-inducible factor (oxygen sensing) pathway, resulting in a coordinated erythropoietic response, leading to increased endogenous erythropoietin production, improved iron absorption and transport, and reduced hepcidin.

Roxadustat is the first HIF-PHI approved by the European Medicines Agency and reimbursed in Italy by the Italian Medicines Agency for the treatment of adult patients with symptomatic CKD-related anemia. The authorization was based on the outcome of a globally conducted phase 3 clinical trial that included eight multicenter randomized trials.

In the Journal of Nephrology [doi.org/10.1007/s40620-023001849-9], the researchers provided an overview of the placement and use of roxadustat for the management of patients with CKD-related anemia.

Source: Journal of Nephrology