A COMPARATIVE STUDY OF DESIDUSTAT AND ERYTHROPOIETIN STIMULATING AGENTS IN CKD-RELATED ANEMIA

Introduction:

Anemia in chronic kidney disease (CKD) associated with morbidity it encounters of poor  quality of life. Standard of care in current scenario is  erythropoietin-stimulating agents (ESAs). It caries limitation like need for injections, cost, and handling issues persist (Cold Chain) with ESAs. Desidustat, a novel hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), presents an oral alternative approved for CKD-related anemia by stimulating endogenous erythropoietin production. This study aims to compare the efficacy and safety of Desidustat with ESAs in CKD patients with anemia.

Methods:

This prospective, observational study was conducted at the Department of Nephrology, Apollo Hospital International Limited, Gandhinagar, from February 1, 2023, to June 30, 2024. A total of 60 patients with CKD-related anemia were enrolled, with 30 patients receiving Desidustat and 30 receiving ESA therapy (epoetin alfa). According to the eligibility criteria patients were enrolled in the study. Hb levels were assessed at baseline, 15 days, and 1, 2, and 3 months after initiating treatment. Data on cost, ease of handling and administration, compliance, and adverse events were also collected.

Results:

The mean age of participants was 50.5 years and 53.9 years in the Desidustat and ESA groups(p = 0.31). Both groups exhibited a significant rise in hemoglobin levels over time. Baseline mean Hb levels were 7.9 g/dL in the Desidustat group and 7.8 g/dL in the ESA group (p = 0.47). By the third month, Hb levels increased to 9.3 g/dL in the Desidustat group and 9.1 g/dL in the ESA group (p = 0.48), with no statistically significant difference in Hb improvement between the groups. Desidustat was also found to be significantly more cost-effective, with 96.7% of patients finding it feasible compared to 66% in the ESA group (p < 0.01). A higher proportion of Desidustat patients reported ease of administration (96.7% vs. 70%, p < 0.01) and storage (100% vs. 83.3%, p < 0.05). Compliance rates were comparable between groups (80% vs. 73.3%, p = 0.54). Adverse events were minimal and comparable in both groups.

Conclusions:

Desidustat offers a comparable rise in hemoglobin levels to ESAs in CKD-related anemia, with additional benefits of reduced cost, ease of administration, and ease of storage.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.