Erythropoiesis-stimulating agents (ESAs) are widely used to treat anaemia in patients with kidney disease. A potential alternative approach is to increase erythropoietin production using small-molecule inhibitors of prolyl hydroxylase domain (PHD) enzymes. Recent phase III trials of the PHD inhibitor roxadustat demonstrate similar efficacy and safety to ESAs.
This is a preview of subscription content, access via your institution
Relevant articles
Open Access articles citing this article.
-
Prolyl hydroxylase domain inhibitor is an effective pre-hospital pharmaceutical intervention for trauma and hemorrhagic shock
Scientific Reports Open Access 16 February 2024
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Chen, N. et al. Roxadustat treatment for anemia in patients undergoing long-term dialysis. N. Engl. J. Med. https://doi.org/10.1056/NEJMoa1901713 (2019).
Chen, N. et al. Roxadustat for anemia in patients with kidney disease not receiving dialysis. N. Engl. J. Med. https://doi.org/10.1056/NEJMoa1813599 (2019).
Winearls, C. G. et al. Effect of human erythropoietin derived from recombinant DNA on the anaemia of patients maintained by chronic haemodialysis. Lancet 2, 1175–1178 (1986).
Eschbach, J. W. et al. Recombinant human erythropoietin in anemic patients with end-stage renal disease. Results of a phase III multicenter clinical trial. Ann. Intern. Med. 111, 992–1000 (1989).
Whoriskey, P. Anemia drug made billions, but at what cost? The Washington Post https://www.washingtonpost.com/business/economy/anemia-drug-made-billions-but-at-what-cost/2012/07/19/gJQAX5yqwW_story.html (2012).
Rossert, J., Casadevall, N. & Eckardt, K. U. Anti-erythropoietin antibodies and pure red cell aplasia. J. Am. Soc. Nephrol. 15, 398–406 (2004).
Singh, A. K. et al. Correction of anemia with epoetin alfa in chronic kidney disease. N. Engl. J. Med. 355, 2085–2098 (2006).
Pfeffer, M. A. et al. A trial of darbepoetin alfa in type 2 diabetes and chronic kidney disease. N. Engl. J. Med. 361, 2019–2032 (2009).
Manns, B. J. & Tonelli, M. The new FDA labeling for ESA-implications for patients and providers. Clin. J. Am. Soc. Nephrol. 7, 348–353 (2012).
Maxwell, P. H. & Eckardt, K. U. HIF prolyl hydroxylase inhibitors for the treatment of renal anaemia and beyond. Nat. Rev. Nephrol. 12, 157–168 (2016).
Acknowledgements
Work in the author’s laboratory is funded by the Wellcome Trust and the Rosetrees Trust.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
P.H.M. is a scientific founder and holds equity in ReOx Ltd. He has received a speaker honorarium from Fibrogen. He is head of the School of Clinical Medicine at the University of Cambridge, which has strategic partnerships with AstraZeneca and GlaxoSmithKline, both of which are developing PHD inhibitors for the treatment of renal anaemia.
Rights and permissions
About this article
Cite this article
Maxwell, P.H. A new approach to treating renal anaemia. Nat Rev Nephrol 15, 731–732 (2019). https://doi.org/10.1038/s41581-019-0207-7
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41581-019-0207-7
