Abstract: FR-PO1161
Comparative Effectiveness of Roxadustat vs. Erythropoiesis-Stimulating Agents (ESAs) on Anemia and Kidney Outcomes among Patients with CKD: A Retrospective Cohort Study
Session Information
- CKD: Kidney Function and Extrarenal Complications
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Wang, Jinwei, Peking University First Hospital, Beijing, Beijing, China
- Zhang, Luxia, Peking University First Hospital, Beijing, Beijing, China
- Zhao, Ming-Hui, Peking University First Hospital, Beijing, Beijing, China
Background
Anemia is a common complication of chronic kidney disease (CKD), causing adverse outcomes. Traditional treatments, including iron and erythropoiesis stimulating agents (ESAs), may arouse drug-related adverse events, while the newly developed hypoxia inducible factor prolyl hydroxylase inhibitor (HIF-PHI) demonstrated both efficacy and safety. However, previous evidence largely comes from clinical trials and mainly focused on patients with kidney failure. The “head-to-head” comparison of the effectiveness in real-world setting among patients with CKD regarding HIF-PHI and ESAs is lacking.
Methods
Patients with CKD receiving either intravenous/subcutaneous ESAs or oral Roxadustat capsules (one type of HIF-PHI) were identified from the electronic health records-based CKD registry in Yinzhou district of Ningbo city in China from December of 2018 to December of 2021. The propensity score-based inverse probability of treatment weighting was used to control confounding. The difference regarding hemoglobin (Hb) change between the treatments was evaluated by linear mixed effect model, while association of the treatments with Hb response (Hb>110 g/L with an absolute increase of Hb ≥10 g/L from a baseline of ≥80 g/L or ≥20 g/L from a baseline of <80 g/L) and composite kidney outcomes (initiation of kidney replacement therapy, doubling of serum creatinine or ≥50% reduction of kidney function) by Cox regression model.
Results
Totally, 473 patients receiving ESAs and 189 receiving Roxadustat were identified, with a median follow-up of 8.4 (interquartile range: 6.5-21.8) and 5.8 (3.3-11.3) months, respectively, for Hb response. The Roxadustat group demonstrated a significantly faster Hb increase rate than ESAs group (9.49 [95% confidence interval: 3.66-15.32] g/L/year versus 1.91 [0.83, 2.99] g/L/year, P=0.01). The Roxadustat group also showed a faster achievement of Hb response (weighted hazard ratio=1.496 [95% confidence interval: 1.121-1.652]) during 52 weeks of follow-up. There were 43 and 192 composite kidney outcomes occurred in the Roxadustat and ESAs group, respectively, corresponding to lower risk of composite kidney outcomes (weighted hazard ratio=0.686 [0.489-0.963]).
Conclusion
This study suggests patients with CKD receiving Roxadustat treatment has faster increase of Hb and lower risk of kidney outcomes than ESAs.