Abstract: PO0266
Effects of Roxadustat Treatment on Serum Parathyroid Hormone (PTH) in Hemodialysis Patients with Erythropoiesis-Stimulating Agent (ESA) Resistant Anemia
Session Information
- Anemia and Iron Management
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 200 Anemia and Iron Metabolism
Authors
- Hashiguchi, Jyunichiro, Nagasaki Kidney Center, Nagasaki, Japan
- Funakoshi, Satoshi, Nagasaki Kidney Center, Nagasaki, Japan
- Sawase, Kenji, Nagasaki Kidney Center, Nagasaki, Japan
- Kawazu, Tayo, Nagasaki Kidney Center, Nagasaki, Japan
- Hayashi, Kanako, Nagasaki Kidney Center, Nagasaki, Japan
- Yamaguchi, Kosei, Nagasaki Kidney Center, Nagasaki, Japan
- Kitamura, Mineaki, Nagasaki Kidney Center, Nagasaki, Japan
- Harada, Takashi, Nagasaki Kidney Center, Nagasaki, Japan
- Nishino, Tomoya, Nagasaki University Hospital, Nagasaki, Japan
Background
Roxaduastat, an oral HIF-prolyl hydroxylase inhibitor, is shown to stimulate erythropoiesis thereby improving iron metabolism. Of note, recent research suggests that iron utilization plays a key role in bone turnover in hemodialysis patients.
Methods
A total of 64 hemodialysis patients with ESA-resistant anemia despite high-dose epoetin α (3000 units 3 times weekly) therapy participated in the study after giving informed consent. Patients were switched from intravenous epoetin α to oral roxaduastat therapy (100 mg 3 times weekly), with no dose change in any of the iron supplements, calcimimetics or vitamin D formulations being used, and were assessed after 8 weeks of roxaduastat therapy for improvements in anemia, as well as for changes in parameters related to iron metabolism and bone turnover.
Results
The study included 39 men and 25 women (age, 70.8 ± 11.8 years; Hb concentration, 10.3 ± 1.2 g/dL). After 8 weeks, the Hb concentration tended to be increased (P = 0.06). As shown in Table, the serum iron, ferritin concentration and TSAT significantly decreased (p < 0.05), suggesting increased iron utilization. Again, the serum calcium concentration was significantly decreased from 8.54 to 8.36 mg/dL, while the intact-PTH (i-PTH) concentration was significantly decreased from 98.61 to 75.80 pg/mL (P < 0.001).
Conclusion
Switching hemodialysis patients with ESA-resistant anemia from intravenous ESA to oral roxaduastat therapy may result in a decrease in their serum PTH concentrations presumably through improved iron utilization, thus potentially improving their bone mineral metabolism.
Effects of Roxadustat Treatment on HD Patients with ESA-resistant Anemia
| Week 0 | Week 4 | Week 8 | |
| Hb (g/dL) | 10.36±0.85 | 10.62±1.28 | 10.52+±1.28 |
| iron (μg/dL) | 49.48±17.69 | 45.86±25.75* | 45.61±23.15* |
| ferritin (g/dL) | 63.87±66.72 | 56.08±97.60* | 46.96±62.61* |
| TSAT | 0.18±0.06 | 0.14±0.08* | 0.14±0.10* |
| calcium (mg/dL) | 8.54±0.65 | 8.43±0.72* | 8.36±0.81* |
| i-PTH (pg/mL) | 98.61±88.72 | 70.38±61.13** | 75.80±75.86** |
* p<0.05, ** p<0.01
Funding
- Private Foundation Support