Addition of Roxadustat to Erythropoiesis-stimulating Agent (ESA)
Effectively Corrects ESA-hyporesponsive Anemia in Peritoneal Dialysis
Background Erythropoiesis-stimulating agent (ESA) hyporesponsiveness is
an important cause for the undertreatment of anemia. This study aimed to
investigate the effectiveness and safety of adding HIF-PHI (roxadustat)
to ESA for the treatment of ESA-hyporesponsive anemia in Peritoneal
Dialysis (PD) patients. Methods This was a single-center
prospective-designed study in PD patients of Huashan Hospital, Fudan
University. Patients with ESA-hyporesponsive anemia were enrolled from
January 2020 to April 2020 with a 24-week follow-up period. Patients
were added with roxadustat at a starting dose of 50 or 100 mg thrice
weekly without changing the ESA dose. Roxadustat and ESA dose
adjustments were made as needed to maintain Hb levels within 11.0–13.0
g/dL. Efficacy outcomes and safety were assessed. Results A total of
nine patients were recruited in the study. Both the cumulative
responsive rate and the maintenance rate of patients with
Hb>11g/dL were 100%. Six out of nine patients had ESA dose
reduced from 15,000 UI/week or more to 7000 IU/week or less at week 24.
No drug-related severe adverse event was reported in this study.
Conclusion The present study showed that the addition of roxadustat not
only effectively corrected anemia in patients who were resistant to ESA,
but also reduced the dose of ESA.