Roxadustat: Do we know all the answers?

Authors

  • Qiu-Yu Li Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China.
  • Qian-Wen Xiong Department of Surgical Oncology, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Xuefeng Yao The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • Fei Liu Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China. https://orcid.org/0000-0001-9098-9155
  • Xiaoxiao Tang Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China.
  • Haidong Fu Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China.
  • Tong Tong The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • Jianhua Mao Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China.
  • Wan-Xin Peng Department of Surgical Oncology, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. https://orcid.org/0000-0002-2551-8899

DOI:

https://doi.org/10.17305/bb.2022.8437

Keywords:

Erythropoietin, HIF-PHI, roxadustat, renal anemia, therapeutic potential

Abstract

Anemia is a common complication of chronic kidney disease (CKD), and its prevalence rises as the disease progresses. Intravenous or subcutaneous erythropoiesis-stimulating agents (ESAs) are advised to treat CKD-associated anemia, since shortage of erythropoietin (EPO) and iron are the main cause of anemia. However, ESA resistance and safety have spurred a lot of interest in the development of alternate anemia therapies. Roxadustat, an orally administered hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) that increases erythropoiesis and may modulate iron metabolism, was recently licensed in China, Chile, South Korea, Japan and the European Union for the treatment of CKD-related anemia. Despite this, clinical trials have shown a number of adverse effects, including cardiovascular disease, hyperkalemia, and infections. In addition, of concern is roxadustat's possible effects on other organs and systems. In this review, based on clinical evidence, we discuss the potentially detrimental effects of roxadustat to the known biology on systems other than kidney, and the need for long-term follow-up in order for roxadustat to be approved in more countries in the future.

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Roxadustat: Do we know all the answers?

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Published

01-05-2023

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How to Cite

1.
Roxadustat: Do we know all the answers?. Biomol Biomed [Internet]. 2023 May 1 [cited 2024 May 19];23(3):354–363. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/8437