Roxadustat, for patients both on dialysis and not on dialysis, may soon be marketed to treat anemia in patients with chronic kidney disease (CKD) if approved by the U.S. Food and Drug Administration (FDA), but more possible benefits are being discovered. New research on oral roxadustat shows the drug’s potential to lower the cholesterol of patients with anemia and CKD. In addition to lowering this vulnerable population’s low-density lipoprotein cholesterol (LDL-C), studies also show that it may reduce dialysis-dependent patients’ risk of hospitalization for congestive heart failure.

What they did 

Researchers pooled data from six phase III (3) studies and focused on three populations:

• Non-dialysis dependent patients with CKD (NDD-CKD)
• Dialysis-dependent patients with CKD (DD-CKD)
• Patients with incident dialysis (ID-DD-CKD), defined as dialysis for less than four months

The investigators averaged the mean changes from baseline in LDL-C over weeks 12 to 28 and analyzed for treatment differences.

What they found

The treatment differences in LDL levels in patients with CKD and anemia were statistically significant across all three groups:

• In patients with NDD-CKD, there was a 17.2% reduction in LDL cholesterol for those on roxadustat.
• In patients with DD-CKD, there was an 18.5% reduction in LDL-C for those taking roxadustat. 
• In patients with ID-DD-CKD, there was a 21.5% reduction in LDL-C for the roxadustat group.

It is important to note that it’s unclear which patients were on statins (medications that lower cholesterol), which is a limitation of the study. 

In the same study, investigators also examined congestive heart failure (CHF), a common related medical condition in patients with CKD. They noted a prevalence ranging from about 20% in patients with mild CKD age 65 and older to 40% in patients on hemodialysis. From their research, they discovered that the drug led to a 27% reduction rate in hospitalizations related to CHF in the patient group that is dialysis-dependent when compared with the injection epoetin alfa. 

What it means

In addition to its effectiveness in improving anemia in CKD patients, other clinical trials are showing roxadustat’s ability to tackle other health concerns, such as potentially reducing LDL cholesterol and patients’ risk for hospitalization from congestive heart failure. 

*Inserro, A. (2020, Oct. 24). Roxadustat Lowers LDL in Patients With CKD, Anemia. American Journal of Managed Care. https://www.ajmc.com/view/roxadustat-lowers-ldl-in-patients-with-ckd-anemia