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Abstract: TH-PO694

Real-World Use of Roxadustat, an HIF-PH Inhibitor, in the China Dialysis and Practice Patterns Study (DOPPS, 2019-2021)

Session Information

  • Anemia and Iron Metabolism
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism


  • Zhao, Xinju, Peking University People's Hospital, Beijing, China
  • Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Gan, Liangying, Peking University People's Hospital, Beijing, China
  • Hou, Fan Fan, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
  • Liang, Xinling, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
  • Chen, Xiaonong, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
  • Ni, Zhaohui, Shanghai Jiao Tong University, Shanghai, China
  • Chen, Yuqing, Peking University First Hospital, Beijing, Beijing, China
  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Zuo, Li, Peking University People's Hospital, Beijing, China

Erythropoiesis stimulating agents (ESA) have been the mainstay to treat anemia in hemodialysis (HD) patients for decades but have been associated with adverse outcomes. The Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitor roxadustat (roxa), is an oral anemia correction agent commercially available in China since 2018. However, little is known about its use in real-world settings. The aim of this study was to explore roxa uptake in Chinese in-center HD patients.


China DOPPS participants initiating roxa were identified and compared to the overall China DOPPS in-center HD population (2019-21).


Among 1763 participants roxa prescription increased from 0 (Jan 2019) to 9.1% (Nov 2021, Figure). Compared to overall, patients starting roxa during follow-up (n=116) were older (65 v 61 years); on dialysis longer (5.0 v 3.1 years); more likely diabetic (50 v 36%) or female (51 v 40%); and had lower Hgb (9.3 v 10.8 g/dL), higher CRP (0.57 v 0.35 mg/dL), and higher ferritin (300 v 212 ng/mL) levels. Compared to values at roxa initiation, Hgb increased (10.2 g/dL), ferritin decreased (204 ng/mL), CRP and s. potassium were stable, and ESA use decreased from 93 to 70% two months after roxa initiation (v 91% overall ESA use). IV iron (~30%) and oral iron (~20%) use were similar from before to after roxa initiation, and to the overall cohort.


Per DOPPS China data, approximately 10% of HD patients in major Chinese cities are now prescribed a HIF-PH inhibitor. Impressions based on preliminary data include: roxa is prescribed to both prevalent and incident HD patients, appears to correct renal anemia, may improve iron metabolism, has no effect on potassium, and is often prescribed concurrently with an ESA. Longitudinal evaluation to assess dosing patterns, effectiveness, safety, and subgroup effects of HIF-PH inhibitors in the real-world is warranted in future studies.


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