EFFICACY OF DESIDUSTAT IN FUNCTIONAL IRON DEFICIENCY ANAEMIA IN DIALYSIS-DEPENDENT CKD PATIENTS WITH ELEVATED FERRITIN: A SINGLE-CENTRE STUDY.

8 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-2314, Poster Board= SAT-076

Introduction:

Hepcidin, a key regulator of iron, is typically elevated in chronic inflammatory diseases, contributing to iron sequestration and reduced erythropoiesis, which play a critical role in developing functional iron deficiency in CKD patients. Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) like Desidustat offer a novel therapeutic approach by modulating the hypoxia pathway, potentially improving anemia management by reducing hepcidin levels and enhancing iron availability.

Methods:

This single-arm study assessed the efficacy of Desidustat in DD-CKD patients with serum ferritin levels exceeding 700 ng/ml. Patients received Desidustat at 100 mg thrice weekly, with dose escalation to 150 mg in 9 patients based on clinical response. Iron indices, including serum ferritin, total iron-binding capacity (TIBC), transferrin saturation (TSAT), serum iron, and hepcidin, were measured at baseline (February 2024), and monthly until August 2024. Hemoglobin levels were monitored to assess the hematologic response. Statistical analysis was performed using one-way ANOVA, with p<0.05 considered significant.

Results:

Figure1:illustrates the trend in serum hemoglobin levels from February to August 2024.

A total of 27 patients were enrolled according to the criteria of serum ferritin level. Male to male-to-female ratio is 2:1. the mean age of the patients was 60.5 ± 13 years and the mean weight was 66.2 ± 12 kg. Significant reductions were observed in serum ferritin levels from 1085.83 ng/ml in February 2024 to 789.14 ng/ml in August 2024 (p=0.003). Hepcidin levels also decreased significantly from 64.60 ng/ml to 54.87 ng/ml (p=0.027). Other iron parameters, including serum iron, TIBC, and TSAT, showed non-significant changes. Hemoglobin levels fluctuated throughout the study, with an initial increase followed by stabilization (Figure 1). Non-significant improvement was observed in TIBC, TSAT and Serum Iron levels. Patients maintained good compliance with the therapy.  

Table 1: Change in Iron Indices

Parameter

Feb-24

May-24

Aug-24

P value*

Serum Iron (mcg/dl)

56.68

68.84

73.24

0.129

TIBC (mcg/dl)

202.39

219.67

213.19

0.294

TSAT (%)

27.85

28.95

35.28

0.110

Ferritin (ng/ml)

1085.83

848.55

789.14

0.003#

Hepcidin (ng/ml)

64.60

69.70

54.87

0.027#

* One Way Anova; # Significant reduction.

 

Conclusions:

Desidustat effectively reduced serum ferritin and hepcidin levels in DD-CKD patients with high baseline ferritin, suggesting its potential to improve iron utilization and manage anemia in this challenging patient population. The observed stabilization in hemoglobin levels supports the efficacy of Desidustat in DD CKD patients

I have no potential conflict of interest to disclose.

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