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缺氧诱导因子脯氨酰羟化酶抑制剂:慢性肾脏病贫血治疗的范式转变?

Hypoxia-inducible factor prolyl hydroxylase inhibitors: a paradigm shift for treatment of anemia in chronic kidney disease?

机构信息

Department of Clinical Pharmacy, University of Michigan , Ann Arbor, MI, USA.

Department of Chemistry and Biochemistry, Brigham Young University , Provo, UT, USA.

出版信息

Expert Opin Investig Drugs. 2020 Aug;29(8):831-844. doi: 10.1080/13543784.2020.1777276. Epub 2020 Jun 16.


DOI:10.1080/13543784.2020.1777276
PMID:32476498
Abstract

INTRODUCTION: The hypoxia-inducible factor prolyl hydroxylase (HIF-PH) pathway is responsible for regulating the biosynthesis of erythropoietin (EPO) and maintaining iron homeostasis. Investigational drugs that target the HIF-PH pathway are promising alternatives for treating anemia in Chronic Kidney Disease (CKD). AREAS COVERED: This review summarizes recent advances focused on the clinical development of HIF-PH inhibitors (HIF-PHIs) as potentially novel therapies in the treatment of anemia in CKD based on publications available on PubMed and restricted Google searches. We provide a comparison between HIF-PHIs regarding their pharmacokinetics, dosing regimens and safety concerns, structure-activity relationships, and alterations in key laboratory parameters observed in animal models and clinical trials. EXPERT OPINION: HIF-PHIs may be advantageous in some aspects compared to the conventional erythropoiesis-stimulating agents (ESAs). While ESAs could increase the risk of cardiovascular events due to rapid rises in ESA blood levels, HIF-PHIs have been reported to maintain EPO concentrations at levels that are closer to the normal physiological ranges. Although HIF-PHIs have been demonstrated to be relatively safe and effective in clinical trials, long-term safety data are needed in order to establish whether these therapeutic agents will lead to a major paradigm change in the treatment of anemia of CKD.

摘要

简介:缺氧诱导因子脯氨酰羟化酶(HIF-PH)通路负责调节促红细胞生成素(EPO)的生物合成和维持铁稳态。靶向 HIF-PH 通路的研究性药物是治疗慢性肾脏病(CKD)贫血的有前途的替代方法。

涵盖领域:本综述总结了基于 PubMed 上发表的文献和受限的谷歌搜索,针对 HIF-PH 抑制剂(HIF-PHIs)作为治疗 CKD 贫血的潜在新型疗法的临床开发的最新进展。我们比较了 HIF-PHIs 在药代动力学、剂量方案和安全性问题、结构-活性关系以及在动物模型和临床试验中观察到的关键实验室参数的改变方面的差异。

专家意见:与传统的促红细胞生成刺激剂(ESA)相比,HIF-PHIs 在某些方面可能具有优势。虽然 ESA 由于 ESA 血液水平的快速升高而增加心血管事件的风险,但据报道,HIF-PHIs 可将 EPO 浓度维持在更接近正常生理范围的水平。尽管 HIF-PHIs 在临床试验中已被证明相对安全有效,但仍需要长期安全性数据,以确定这些治疗药物是否会导致 CKD 贫血治疗的重大范式转变。

相似文献

[1]
Hypoxia-inducible factor prolyl hydroxylase inhibitors: a paradigm shift for treatment of anemia in chronic kidney disease?

Expert Opin Investig Drugs. 2020-8

[2]
Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients.

Ren Fail. 2020-11

[3]
Hypoxia-inducible factor-prolyl hydroxylase inhibitors for renal anemia in chronic kidney disease: Advantages and disadvantages.

Eur J Pharmacol. 2021-12-5

[4]
Investigational hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHI) for the treatment of anemia associated with chronic kidney disease.

Expert Opin Investig Drugs. 2018-7-12

[5]
Effects of hypoxia-inducible factor-prolyl hydroxylase inhibitors . erythropoiesis-stimulating agents on iron metabolism in non-dialysis-dependent anemic patients with CKD: A network meta-analysis.

Front Endocrinol (Lausanne). 2023

[6]
A spotlight on using HIF-PH inhibitors in renal anemia.

Expert Opin Pharmacother. 2024-7

[7]
Future perspectives of anemia management in chronic kidney disease using hypoxia-inducible factor-prolyl hydroxylase inhibitors.

Pharmacol Ther. 2022-11

[8]
Hypoxia-inducible factor prolyl hydroxylase inhibitor in the treatment of anemia in chronic kidney disease.

Curr Opin Nephrol Hypertens. 2020-7

[9]
A Novel Hypoxia-Inducible Factor-Prolyl Hydroxylase Inhibitor (GSK1278863) for Anemia in CKD: A 28-Day, Phase 2A Randomized Trial.

Am J Kidney Dis. 2016-1-27

[10]
Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors in Kidney Disease.

NEJM Evid. 2024-9

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Low cholesterol levels are good markers for central hypothyroidism in case with dialysis using roxadustat.

Clin Case Rep. 2024-9-3

[2]
Physician and Patient Preferences for Treatment of Anemia Associated with Chronic Kidney Disease in Japan: A Survey Including Best-Worst Scaling.

Patient Prefer Adherence. 2024-7-31

[3]
An Updated Review of the Management of Chronic Heart Failure in Patients with Chronic Kidney Disease.

Rev Cardiovasc Med. 2024-4-11

[4]
Hypoxia-inducible factor-prolyl hydroxylase inhibitors for treatment of anemia in chronic kidney disease: a systematic review and network meta-analysis.

Front Pharmacol. 2024-7-10

[5]
SRS 16-86 promotes diabetic nephropathy recovery by regulating ferroptosis.

Exp Physiol. 2024-7

[6]
Effect of roxadustat on iron metabolism in patients with peritoneal dialysis: a real-world 24-week study.

Eur J Med Res. 2023-11-7

[7]
Genetic Background of Congenital Erythrocytosis.

Genes (Basel). 2021-7-28

[8]
HIF-α Prolyl Hydroxylase Inhibitors and Their Implications for Biomedicine: A Comprehensive Review.

Biomedicines. 2021-4-24

[9]
Iron Therapy in Chronic Kidney Disease: Days of Future Past.

Int J Mol Sci. 2021-1-20

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