For many people with chronic kidney disease (CKD), their kidneys are unable to help in the production of red blood cells. This leads to anemia, which can be dangerous if untreated. 

Fortunately, treatment options are approved by the Food and Drug Administration (FDA), and another is showing promising results in clinical trials. Learn more about the research findings on the hypoxia-inducible factor prolyl-hydroxylase inhibitor (HIF-PHI) daprodustat.* 

What Is Daprodustat?

Erythropoiesis refers to the process that produces red blood cells. Erythropoiesis-stimulating agents (ESAs) are commonly used for patients during dialysis. Currently, ESAs can only be given as a shot under the skin or into a vein. 

Since ESAs are effective in treating anemia from CKD, researchers developed an oral alternative called daprodustat. Their investigation compared ESAs and daprodustat to determine the better option for CKD patients.

What Did Researchers Find?

Using participants from A Study of Cardiovascular Events in Diabetes (ASCEND) trials, researchers measured the efficacy and safety of oral daprodustat in CKD patients with and without dialysis. 

Their findings included:

• From baseline to weeks 28 through 52, there was an average hemoglobin level increase of 0.28±0.02 g/dL among dialysis patients and 0.66±0.02 g/dL among non-dialysis CKD patients. The results showed more improved hemoglobin levels with daprodustat compared to ESA. 
• Comparing major adverse cardiovascular events, daprodustat appeared just as safe for the heart as ESAs in all CKD patients. 
• However, in the non-dialysis CKD population, there was a higher rate of cancer-related death or tumor progression or recurrence and esophageal or stomach erosions in the daprodustat group.

What It Means

Anemia in CKD patients can lead to increased morbidity, mortality, and a reduced quality of life. According to Dr. Ajay Singh, chair of the ASCENT program’s Executive Steering Committee, patients will feel exhausted and unable to function highly in day-to-day life with untreated anemia. 

While hemodialysis patients are able to receive ESAs during their treatment, many non-dialysis CKD patients are not having their anemia managed adequately. Only 30% of non-dialysis patients that should be prescribed ESAs actually are. This is partly due to the method of administration; an injectable medication would need to be administered by a healthcare provider. In addition, many patients feel uncomfortable with needles and shots. 

“This creates compliance issues for non-dialysis patients, for which we know treatment is currently underutilized,” Dr. Singh underscored. “An oral option that can be as safe and effective as the current standard of care, such as what was found in the ASCEND program with daprodustat, has the potential to be transformative for patient care.”

*Monaco, K. (2021, December 16). Investigational Oral CKD-Anemia Agent Effective, Safe. MedPage Today. https://www.medpagetoday.com/meetingcoverage/asn/95485