Key result
Prolyl-hydroxylase inhibitors show potential as oral alternatives to erythropoietin for CKD anemia pending safety trials.
Why the study?
Prolyl-hydroxylase inhibitors are novel oral agents under development for anemia in chronic kidney disease, warranting a review of their biology, potential advantages, disadvantages, and current trials.
Are prolyl-hydroxylase inhibitors effective and safe for the treatment of anemia in patients with chronic kidney disease?
Are prolyl-hydroxylase inhibitors effective and safe for the treatment of anemia in patients with chronic kidney disease?
Prolyl-hydroxylase inhibitors represent a promising novel oral therapy for anemia in chronic kidney disease, pending definitive safety data from large phase III trials.
May support oral alternatives for CKD anemia; hypothesis-generating and should not change practice pending phase III safety data.
PURPOSE OF REVIEW: Prolyl-hydroxylase inhibitors are a novel class of orally administered drugs that are under development for the treatment of anemia in patients with chronic kidney disease. This review discusses the biology of these drugs and their target - hypoxia-inducible factor and potential advantages and disadvantages of these therapies. Finally, we will discuss current trials in patients with both chronic kidney disease and end-stage renal disease. RECENT FINDINGS: Recent smaller studies have found that prolyl-hydroxylase are as effective as erythropoietin in treating anemia of chronic kidney disease. We do not yet know if they have the same cardiovascular and cancer-related risk profile and these questions will be answered by large phase III trials that are ongoing. SUMMARY: Although prolyl hydroxylase inhibitors have much potential, questions remain regarding their efficacy and safety. Should these concerns prove to be unfounded, the treatment of anemia in chronic kidney disease will likely be transformed over the next decade.
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McMahon et al. (2019) conducted a review in Anemia in chronic kidney disease. Prolyl-hydroxylase inhibitors vs. Erythropoietin was evaluated. Prolyl-hydroxylase inhibitors show potential as an oral alternative to erythropoietin for treating anemia in chronic kidney disease, pending results from large phase III trials regarding safety.
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