|The following article features coverage from the National Kidney Foundation’s virtual 2020 Spring Clinical Meetings. Click here to read more of Renal and Urology News’ conference coverage.|
Patients with chronic kidney disease (CKD) stage 3 to 5d who receive roxadustat have less need for red blood cell (RBC) transfusions, according to study findings presented at the live virtual 2020 National Kidney Foundation Spring Clinical Meetings.
Roxadustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), promotes erythropoiesis by increasing endogenous erythropoietin, improving iron regulation, and reducing hepcidin, investigators noted.
In pooled results from 6 major phase 3 trials, roxadustat reduced the risk for RBC transfusion within 1 year by 74% compared with placebo in nondialysis patients and by 18% compared with epoetin alfa in dialysis patients, Stephen Fishbane, MD, of Northwell Health in Great Neck, New York, and colleagues reported.
The nondialysis CKD trials – OLYMPUS, ANDES, and ALPS – involved 2368 roxadustat and 1865 placebo recipients, both with mean baseline hemoglobin (Hb) values of 9.10 g/dL. Pooled results showed that CKD patients with baseline Hb less than 8 g/dL and estimated glomerular filtration rates lower than 15 mL/min/1.73 m2 had a higher likelihood of RBC transfusion. Patients without iron repletion also had greater risk.
The dialysis trials – ROCKIES, SIERRAS, and HIMALAYAS – included 1929 roxadustat and 1928 epoetin alfa users with mean baseline Hb of 9.63 vs 9.67 g/dL, respectively. The need for RBC transfusion with roxadustat varied among studies. Analyses revealed that older patients aged 65 years or more and those with a dialysis vintage longer than 4 months and baseline Hb of 10 g/dL or higher were more likely to receive RBC transfusions.
RBC transfusions “may cause allergic or immune reactions, lead to allo-sensitization, or rarely transmit infections, so treatments reducing transfusions are desirable,” Dr Fishbane’s team noted.
Disclosure: This clinical trial was supported by AstraZeneca, Fibrogen, and Astellas. Please see the original reference for a full list of authors’ disclosures.
Read more of our coverage of the National Kidney Foundation’s virtual 2020 Spring Clinical Meetings by visiting the conference page.
Fishbane S, Provenzano R, Rastogi A, et al. Roxadustat lowers risk of RBC transfusion in patients with anemia of CKD. Data presented at the live virtual 2020 National Kidney Foundation Spring Clinical Meetings held March 25 to 29. ePoster 186.