Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.
J Clin Pharm Ther. 2022 Oct;47(10):1525-1530. doi: 10.1111/jcpt.13696. Epub 2022 May 28.
Erythropoiesis-stimulating agent (ESA) hyporesponsiveness is an important cause for the undertreatment of anaemia. A decrease in haemoglobin (Hb) levels was observed during the initial stage of the conversion from ESA to roxadustat. The study aims to investigate the effectiveness and safety of adding roxadustat to an ESA for the treatment of ESA-hyporesponsive anaemia in patients on peritoneal dialysis (PD).
Patients on PD with ESA-hyporesponsive anaemia were enrolled from January 2020 to April 2020 with a 24-week follow-up period. Patients were treated with roxadustat at a starting dose of 50 or 100 mg thrice weekly without changing the ESA dose. Roxadustat and ESA dose adjustments were made as needed to maintain Hb levels within 11.0 to 13.0 g/dl. Efficacy outcomes and safety were assessed.
Nine patients were recruited in the study. Both the cumulative responsive rate and maintenance rate of Hb > 11 g/dl were 100%. Six patients required ESA dose reduction from ≥15,000 UI/week to ≤7000 IU/week at week 24. No drug-related severe adverse events were observed in this study.
The addition of roxadustat effectively and smoothly corrected anaemia in patients who were hyporesponsive to ESA, and permitted reduction of the ESA dose.
红细胞生成刺激剂(ESA)低反应性是贫血治疗不足的一个重要原因。在从ESA 转换为罗沙司他的初始阶段,观察到血红蛋白(Hb)水平下降。本研究旨在探讨在腹膜透析(PD)患者中,加用罗沙司他治疗 ESA 低反应性贫血的有效性和安全性。
本研究纳入了 2020 年 1 月至 2020 年 4 月期间接受 PD 治疗且存在 ESA 低反应性贫血的患者,随访时间为 24 周。患者起始接受罗沙司他 50 或 100mg,每周 3 次,ESA 剂量不变。根据需要调整罗沙司他和 ESA 剂量,以维持 Hb 水平在 11.0 至 13.0g/dl 之间。评估疗效和安全性。
本研究共纳入 9 例患者。Hb>11g/dl 的累积应答率和维持率均为 100%。6 例患者在 24 周时需要将 ESA 剂量从≥15,000UI/周减少至≤7000UI/周。本研究未观察到与药物相关的严重不良事件。
加用罗沙司他可有效且平稳地纠正对 ESA 低反应性的患者的贫血,并可减少 ESA 剂量。