This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Go to /pro/cpd-dashboard page

This page is worth 0.05 CPD credits. CPD dashboard

Go to /account/subscription-details page

This page is worth 0.05 CPD credits. Upgrade to Pro

Roxadustat for treating symptomatic anaemia in chronic kidney disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

NICE state that roxadustat is recommended as an option for treating symptomatic anaemia associated with chronic kidney disease (CKD) in adults only if:

  • they have stage 3 to 5 CKD with no iron deficiency and
  • they are not on dialysis at the start of treatment and
  • the company provides roxadustat according to the commercial arrangement

The NICE committee noted that:

  • "..Treatment for symptomatic anaemia associated with chronic kidney disease includes erythropoiesis stimulating agents (ESAs). Roxadustat is an alternative to ESAs. A clinical trial comparing roxadustat with darbepoetin alfa (an ESA) shows that roxadustat works as well as darbepoetin alfa .."

Hypoxia-inducible factor (HIF) proteins

  • under physiological conditions, the HIF proteins are inactivated by enzymes of the prolyl hydroxylase domain (PHD), by targeting HIF proteins for degradation
  • for the condition of hypoxia, the PHD enzymes are downregulated and the HIF proteins stay high
    • HIF proteins stimulate the erythropoietin (EPO) gene in kidney parenchymal cells to produce EPO, as well as other genes, including the iron transporter ferroportin
      • EPO activates red blood cell (RBC) production in bone marrow, and ferroportin facilitates iron absorption in the small intestine

Roxadustat

  • is an orally administered small molecule drug that prevents the enzymatic degradation of HIF-1alpha by inhibiting the PHD enzymes
  • causes the hematocrit rises and hemoglobin concentrations to increase

Reference:

  1. NICE (July 2022). Roxadustat for treating symptomatic anaemia in chronic kidney disease
  2. Czock D, Keller F. Clinical Pharmacokinetics and Pharmacodynamics of Roxadustat. Clin Pharmacokinet. 2022 Mar;61(3):347-362.

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.