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Case series shows 64% response in CKD patients with EPO-induced pure red cell aplasia, suggesting desidustat as a viable treatment option.
Erythropoietin (EPO) supplementation for anemia due to CKD rarely causes pure red cell aplasia (PRCA) initiated by anti-EPO antibodies. Treatment involves discontinuation of erythropoiesis-stimulating agents (ESAs) and administration of immunosuppressive agents like cyclosporine or corticosteroids. The latter increases risk for infection. Desidustat is a hypoxia inducible factor-prolyl hydroxylase (HIF-PH) inhibitor. Its advantage in EPO-induced PRCA in patients with CKD remains unclear. We report a case series on desidustat administration for treating 14 CKD patients with EPO-induced PRCA. Most patients (64%) responded to Desidustat therapy, with a median hemoglobin of 12.5 g/d (range: 8.5-13.6 g/d) at last follow-up. Desidustat can be potentially repurposed in this context with better tolerability. Further randomized controlled trials are warranted.
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Ambattu et al. (2025) studied this question.
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