BACKGROUND Erythropoiesis-stimulating agents(ESAs)have revolutionized the therapeutic strategy for anemia in chronic kidney disease.However,some cases are resistant or hyporesponsive to ESAs.Roxadustat is an oral hypo...BACKGROUND Erythropoiesis-stimulating agents(ESAs)have revolutionized the therapeutic strategy for anemia in chronic kidney disease.However,some cases are resistant or hyporesponsive to ESAs.Roxadustat is an oral hypoxia-inducible factor-prolyl hydroxylase inhibitor that stimulates erythropoiesis and regulates iron metabolism.Here,we describe a hemodialysis patient with refractory anemia who did not respond to traditional treatments and depended on blood transfusion for more than 1 year.After applying Roxadustat,the patient’s anemia improved significantly.CASE SUMMARY A 44-year-old man was diagnosed with uremia accompanied by severe anemia with a hemoglobin(Hb)level ranging from 30-40 g/L.His anemia did not improve after sufficient dialysis or high doses of active ESAs;other causes of anemia were excluded.The patient required approximately 600-1000 mL of red blood cell suspension every 15-30 d for more than 1 year.After accepting Roxadustat therapy,the patient’s anemia symptoms improved significantly;his Hb level gradually increased to 50 g/L,and no further blood transfusions were administered.His Hb level reached 69 g/L by the 34th week.Although a Hb level of 60-70 g/L cannot be considered satisfactory,he no longer required blood transfusions and his quality of life was substantially improved.Roxadustat showed good efficacy and safety in this case.CONCLUSION Roxadustat represents an innovative and effective agent for the clinical treatment of renal anemia caused by multiple complex factors.展开更多
Anemia is the most common complication of inflammatory bowel disease (IBD). Control and inadequate treatment leads to a worse quality of life and increased morbidity and hospitalization. Blood loss, and to a lesser ex...Anemia is the most common complication of inflammatory bowel disease (IBD). Control and inadequate treatment leads to a worse quality of life and increased morbidity and hospitalization. Blood loss, and to a lesser extent, malabsorption of iron are the main causes of iron def iciency in IBD. There is also a variable component of anemia related to chronic inflammation. The anemia of chronic renal failure has been treated for many years with recombinant human erythropoietin (rHuEPO), which significantly improves quality of life and survival. Subsequently, rHuEPO has been used progressively in other conditions that occur with anemia of chronic processes such as cancer, rheumatoid arthritis or IBD, and anemia associated with the treatment of hepatitis C virus. Erythropoietic agents complete the range of available therapeutic options for treatment of anemia associated with IBD, which begins by treating the basis of the inflammatory disease, along with intravenous iron therapy as f irst choice. In cases of resistance to treatment with iron, combined therapy with erythropoietic agents aims to achieve near-normal levels of hemoglobin/hematocrit (11-12 g/dL). New formulations of intravenous iron (iron carboxymaltose) and the new generation of erythropoietic agents (darbepoetin and continuous erythropoietin receptor activator) will allow better dosing with the same eff icacy and safety.展开更多
BACKGROUND Hypoxia-inducible factor prolyl hydroxylase inhibitor is a new class of drugs for treating renal anemia.It is a second-generation hypoxia-inducible factor prolyl hydroxylase-2(PHD2)inhibitor.Roxadustat can ...BACKGROUND Hypoxia-inducible factor prolyl hydroxylase inhibitor is a new class of drugs for treating renal anemia.It is a second-generation hypoxia-inducible factor prolyl hydroxylase-2(PHD2)inhibitor.Roxadustat can effectively increase hemoglobin in patients with dialysis-dependent chronic kidney disease,with an adverse events profile comparable to that of epoetin alfa.We administered roxadustat to a maintenance hemodialysis patient who was allergic to erythropoiesis-stimulating agents(ESAs)and depended on blood transfusion for five years.After applying Roxadustat,the patient’s anemia improved significantly.CASE SUMMARY A 77-year-old Chinese man had type 2 diabetes for 16 years,underwent maintenance hemodialysis for five years,and had fatigue for five years.Laboratory tests showed severe anemia(hemoglobin concentration of 42 g/L).The patient was administered a subcutaneous injection of ESAs before dialysis.He suffered an allergic shock immediately and fainted.His blood pressure dropped to undetectable levels.He was not administered ESAs henceforth.The patient was prescribed iron supplements and received blood transfusions occasionally for five years.His hemoglobin concentration ranged from 42-68 g/L.After taking six weeks of oral roxadustat three times weekly(100 mg TIW),the patient’s hemoglobin concentration increased significantly,and his symptoms decreased.We adjusted the doses of roxadustat,and the hemoglobin concentration was maintained between 97 and 126 g/L.CONCLUSION Oral roxadustat is effective in treating anemia in maintenance hemodialysis patients who cannot be administered ESAs.展开更多
基金Sichuan Clinical Research Center for Nephropathy,No.2019YFS0537-3.
文摘BACKGROUND Erythropoiesis-stimulating agents(ESAs)have revolutionized the therapeutic strategy for anemia in chronic kidney disease.However,some cases are resistant or hyporesponsive to ESAs.Roxadustat is an oral hypoxia-inducible factor-prolyl hydroxylase inhibitor that stimulates erythropoiesis and regulates iron metabolism.Here,we describe a hemodialysis patient with refractory anemia who did not respond to traditional treatments and depended on blood transfusion for more than 1 year.After applying Roxadustat,the patient’s anemia improved significantly.CASE SUMMARY A 44-year-old man was diagnosed with uremia accompanied by severe anemia with a hemoglobin(Hb)level ranging from 30-40 g/L.His anemia did not improve after sufficient dialysis or high doses of active ESAs;other causes of anemia were excluded.The patient required approximately 600-1000 mL of red blood cell suspension every 15-30 d for more than 1 year.After accepting Roxadustat therapy,the patient’s anemia symptoms improved significantly;his Hb level gradually increased to 50 g/L,and no further blood transfusions were administered.His Hb level reached 69 g/L by the 34th week.Although a Hb level of 60-70 g/L cannot be considered satisfactory,he no longer required blood transfusions and his quality of life was substantially improved.Roxadustat showed good efficacy and safety in this case.CONCLUSION Roxadustat represents an innovative and effective agent for the clinical treatment of renal anemia caused by multiple complex factors.
文摘Anemia is the most common complication of inflammatory bowel disease (IBD). Control and inadequate treatment leads to a worse quality of life and increased morbidity and hospitalization. Blood loss, and to a lesser extent, malabsorption of iron are the main causes of iron def iciency in IBD. There is also a variable component of anemia related to chronic inflammation. The anemia of chronic renal failure has been treated for many years with recombinant human erythropoietin (rHuEPO), which significantly improves quality of life and survival. Subsequently, rHuEPO has been used progressively in other conditions that occur with anemia of chronic processes such as cancer, rheumatoid arthritis or IBD, and anemia associated with the treatment of hepatitis C virus. Erythropoietic agents complete the range of available therapeutic options for treatment of anemia associated with IBD, which begins by treating the basis of the inflammatory disease, along with intravenous iron therapy as f irst choice. In cases of resistance to treatment with iron, combined therapy with erythropoietic agents aims to achieve near-normal levels of hemoglobin/hematocrit (11-12 g/dL). New formulations of intravenous iron (iron carboxymaltose) and the new generation of erythropoietic agents (darbepoetin and continuous erythropoietin receptor activator) will allow better dosing with the same eff icacy and safety.
文摘BACKGROUND Hypoxia-inducible factor prolyl hydroxylase inhibitor is a new class of drugs for treating renal anemia.It is a second-generation hypoxia-inducible factor prolyl hydroxylase-2(PHD2)inhibitor.Roxadustat can effectively increase hemoglobin in patients with dialysis-dependent chronic kidney disease,with an adverse events profile comparable to that of epoetin alfa.We administered roxadustat to a maintenance hemodialysis patient who was allergic to erythropoiesis-stimulating agents(ESAs)and depended on blood transfusion for five years.After applying Roxadustat,the patient’s anemia improved significantly.CASE SUMMARY A 77-year-old Chinese man had type 2 diabetes for 16 years,underwent maintenance hemodialysis for five years,and had fatigue for five years.Laboratory tests showed severe anemia(hemoglobin concentration of 42 g/L).The patient was administered a subcutaneous injection of ESAs before dialysis.He suffered an allergic shock immediately and fainted.His blood pressure dropped to undetectable levels.He was not administered ESAs henceforth.The patient was prescribed iron supplements and received blood transfusions occasionally for five years.His hemoglobin concentration ranged from 42-68 g/L.After taking six weeks of oral roxadustat three times weekly(100 mg TIW),the patient’s hemoglobin concentration increased significantly,and his symptoms decreased.We adjusted the doses of roxadustat,and the hemoglobin concentration was maintained between 97 and 126 g/L.CONCLUSION Oral roxadustat is effective in treating anemia in maintenance hemodialysis patients who cannot be administered ESAs.
