Hypoxia-Inducible Factor Activators in Renal Anemia: Current Clinical Experience

Publication date: July 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 4Author(s): Neil S. Sanghani, Volker H. HaaseProlyl hydroxylase domain oxygen sensors are dioxygenases that regulate the activity of hypoxia-inducible factor (HIF), which controls renal and hepatic erythropoietin production and coordinates erythropoiesis with iron metabolism. Small molecule inhibitors of prolyl hydroxylase domain dioxygenases (HIF-PHI [prolyl hydroxylase inhibitor]) stimulate the production of endogenous erythropoietin and improve iron metabolism resulting in efficacious anemia management in patients with CKD. Three oral HIF-PHIs—daprodustat, roxadustat, and vadadustat—have now advanced to global phase III clinical development culminating in the recent licensing of roxadustat for oral anemia therapy in China. Here, we survey current clinical experience with HIF-PHIs, discuss potential therapeutic advantages, and deliberate over safety concerns regarding long-term administration in patients with renal anemia.
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research