Roxadustat – a representative of hypoxia-inducible factor prolyl hydroxylase inhibitors: mechanism of action, safety, and efficacy

Roxadustat is one of several representatives of a new group of drugs known as HIF-PH inhibitors.It is attempting to gain recognition in medicine, mainly in the treatment of anemia in the course of CKD chronic kidney disease.Still, it may also prove effective in anemic patients with other diseases: MDS (myelodysplastic syndrome), PRCA (pure red cell anemia), or CIA (chronic inflammation anemia) such as RA, SLE, UC.This study aims to present the mechanism of action of roxadustat and its impact on hemoglobin levels.It also aims to compare the effectiveness of roxadustat with that of existing therapies for anemia in patients with CKD (Chronic Kidney Disease) and CIA (Chronic Inflammatory Anemia).A review of the scientific literature related on the use of roxadustat in patients with various stages of CKD and in other diseases such as MDS was conducted.Like ESA, roxadustat, induces an increase in RBC count.However, unlike ESA, which are EPO receptor agonists, roxadustat stimulates endogenous EPO production.This allows it to be more effective in achieving and maintaining Hb levels of 11 1g/dL in inflammatory conditions.It achieves this by inhibiting HIF-PH, thereby increasing the cell's ability to survive in hypoxia conditions and enhancing its antioxidant potential.However, due to its polygenic action, it also affects other gene pathways.Further research is needed to understand the full spectrum of the drug.However, both China and the EMA decided to approve the drug for marketing, while the FDA rejected it.