Roxadustat lowers risk of blood transfusions in patients with CKD, ESKD
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Use of the oral hypoxia-inducible factor prolyl hydroxylase inhibitor roxadustat helped reduce the need for red blood cell transfusions compared to placebo in patients with chronic kidney disease not on dialysis, studies show.
“[Red blood cell] RBC transfusions may cause reactions, lead to allo-sensitization or rarely transmit infections, so treatments reducing transfusions are desirable,” Steven Fishbane, MD, and colleagues wrote in an abstract presented at the virtual National Kidney Foundation Spring Clinical Meetings. “This analysis assessed whether (roxadustat) reduced the need for RBC transfusions in patients with nondialysis-dependent (NDD) and dialysis-dependent (DD) chronic kidney disease (CKD) and anemia.”
The researchers examined data from six randomized, phase 3 studies that included patients with stages 3 to 5 CKD. Roxadustat was compared with placebo in NDD-CKD and with epoetin alfa in DD-CKD.
In the NDD-CKD group, 4,277 patients were evaluated. The groups included 2,391 patients using roxadustat and 1,886 patients on placebo. The mean baseline hemoglobin was similar in both groups; patients had been treated with epoetin alfa prior to the trial. Also, “there was reasonable matching at baseline between the two treatment groups” in terms of age, race, sex and comorbid conditions, Fishbane told Healio Nephrology.
The DD-CKD studies included 3,857 patients (1,929 patients using roxadustat; 1,928 using epoetin alfa). Mean baseline hemoglobin was 9.63 ± 1.30 g/dL among patients on roxadustat and was 9.67 ± 1.30 g/dL among patients using epoetin alfa.
In examining the patient groups, patients on roxadustat saw a reduction in RBC transfusions by 74% vs. placebo in NDD patients and by 18% vs. epoetin alfa in DD patients.
“There appeared to be a brisker early erythropoietic effect in the roxadustat group compared to the epoetin alfa group,” Fishbane told Healio Nephrology in speculating why fewer transfusions were needed in the roxadustat group. “However, further studies will need to confirm this finding.” – by Mark E. Neumann
Reference: Fishbane S, et al. Roxadustat lowers risk of RBC transfusion in patients with anemia of CKD. Abstract #186. Presented at: National Kidney Foundation Spring Clinical Meetings; March 26-29, 2020 (virtual meeting).
Disclosure: Fishbane reports he is a principle investigator for Astra Zeneca.