Oral Roxadustat Improved Hemoglobin Levels in Patients With CKD

A retrospective study found roxadustat to be more effective in improving hemoglobin levels in patients who had with chronic kidney disease (CKD) compared with recombinant human erythropoietin.

Patients with chronic kidney disease (CKD) had better improvements in their hemoglobin (Hb) levels when taking oral roxadustat instead of recombinant human erythropoietin (rhEPOA), according to a new study study published in Translational Andrology and Urology.

There are approximately 120 million people in China who have CKD, and 2% will likely progress to end-stage renal disease. Anemia is a complication of CKD that is caused by impaired oxygen sensing during renal failure. Roxadustat has previously been found to treat renal anemia. This current study aimed to evaluate the efficacy of roxadustat in treating renal anemia in patients with CKD who had received the medication for more than 4 weeks.

The study evaluated the median Hb level at baseline and after weeks 4, 12, and 24. Patients on roxadustat (n = 95) were compared with patients who were using rhEPO (n = 285) in the same time period. Baseline Hb levels was 85 g/L in the roxadustat group and 83 g/L in the rhEPO group.

Basic information was collected for all patients, including underlying diseases, personal history, medication history, anemia-related parameters, nutritional indicators, and renal function. Patients were included if they were 19 years and older, had anemia and CKD, and had received rhEPO or roxadustat for 4 weeks or more. Patients were excluded if their anemia was not related to CKD, if they had a follow-up time of less than 12 weeks, or if they had a preexisting malignancy.

The researchers found that the median Hb level was 96 g/L in the roxadustat group and 87 g/L in the rhEPO group after 4 weeks of treatment. This changed to 105 g/L and 94 g/L, respectively, after 12 weeks of treatment. The corresponding 24-week levels were 105 and 97 g/L.

The treatment difference between the roxadustat group and the rhEPO group was 5 g/L (95% CI, 2-9) after 4 weeks of treatment, and this difference increased to 7 g/L (95% CI, 3-11) after 12 weeks of treatment. The treatment difference remained similar after 24 weeks of treatment, with an estimated difference of 5 g/L (95% CI, 1-9).

For the matched cohort, the median maximum Hb level was 108 g/L in the roxadustat group and 101 g/L in the rhEPO group. The 12-week response rates were 65.3% and 50.2%, respectively, with an Hb increase of 10.0 g/L considered as a response to the medication. There were more patients in the roxadustat group who achieved their target Hb levels compared with the rhEPO group after 24 weeks of treatment (52.6% vs 41.4%).

There were some limitations to this study. Some biases may not have been completely eliminated due to the retrospective nature, this study was done in a single center, and iron metabolism, blood lipids, and other nutritional and inflammatory indicators were not detected.

The researchers concluded that roxadustat is better than rhEPO for its effects on patients with anemia in CKD.


Jin C, Zhang Y, Luo C, et al. Comparison of efficacy of roxadustat and erythropoietin for the treatment of renal anemia in patients with chronic kidney disease: a retrospective study. Transl Androl Urol. 2022;11(11):1568-1576. doi:10.21037/tau-22-709

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