Evrenzo (roxadustat) / Astellas, AstraZeneca, FibroGen - LARVOL DELTA

Pharmacological HIF-PH Inhibition Suppresses Myoblast Differentiation Through Continued HIF-1α Stabilization. (PubMed, Int J Mol Sci) - "In vivo, FG-4592 treatment increased HIF-1α protein expression and decreased MyoD, myogenin, and MHC protein expression in gastrocnemius muscle. These findings suggest that pharmacological HIF-PH inhibition suppresses myoblast differentiation through continued HIF-1α stabilization."

Journal • Hematological Disorders • HIF1A • Myogenin

Inhibitors of p53 Apoptosis-Stimulating Protein Mitigate Acute Kidney Injury by Modulating the HIF-1α/SLC7A11 Pathway to Suppress Ferroptosis. (PubMed, J Cell Mol Med) - "The results showed that the ferroptosis level of mice in the I/R group was increased, and the addition of Ferrostatin-1 (Fer-1) and FG-4592 could alleviate the ferroptosis...Similar to HIF-1α, iASPP expression was significantly increased in the I/R group, and overexpression of iASPP upregulated HIF-1α and SLC7A11 expression, consequently mitigating ferroptosis-mediated damage. In summary, our study suggests that iASPP exerts renal protection during I/R injury by regulating the HIF-1α/SLC7A11 axis to suppress ferroptosis."

Journal • Acute Kidney Injury • Nephrology • Renal Disease • Reperfusion Injury • HIF1A • SLC7A11

Hospitalization for Congestive Heart Failure (CHF) Following Treatment With Roxadustat in Patients With or Without a History of CHF: Pooled Post Hoc Analysis of Phase 3 Studies (ERA 2025) - "In patients with DD CKD, regardless of history of CHF, and in patients with NDD CKD with a history of CHF, the results from this post hoc analysis suggest that treatment with roxadustat is non-inferior to ESA for the risk of hospitalization for CHF. In patients with NDD CKD without a history of heart failure, the results should be interpreted cautiously due to the low number of events included in this analysis."

Clinical • P3 data • Retrospective data • Anemia • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Heart Failure • Hematological Disorders • Nephrology • Renal Disease

Roxadustat versus erythropoietin-stimulating agents (ESAs) in kidney transplant patients: a monocentric experience. (ERA 2025) - "Roxadustat increases Hb levels in post kidney transplant anemia similarly to ESA, with not significant changes in immunosuppressant levels or liver enzyme function. Further studies are needed to assess its long-term safety and efficacy."

Clinical • Anemia • Chronic Kidney Disease • Hematological Disorders • Inflammation • Nephrology • Renal Disease • Transplantation

Effect of Roxadustat on Anemia and Renal Function in Patients with Diabetic Kidney Disease (ERA 2025) - "Roxadustat improved anemia in patients with stage III-V DKD and maintained Hb levels ≥100 g/L in the majority of patients. Additionally, Roxadustat helped delay the decline in renal function in DKD patients and improved iron and lipid metabolism as well as quality of life. AEs were consistent with the known safety profile of standard DKD treatment and Roxadustat."

Clinical • Anemia • Cardiovascular • Chronic Kidney Disease • Diabetic Nephropathy • Dyslipidemia • Hematological Disorders • Hypertension • Metabolic Disorders • Nephrology • Pain • Renal Disease • APOA1 • APOB

SGLT2 and HIF-PH inhibitors restore podocyte abnormalities in diabetes (ERA 2025) - " We studied cultured human podocytes treated with high glucose, dapagliflozin or roxadustat. SGLT2i and HIF-PH inhibitor have significant effects on restoring the podocyte morphology, cytoskeleton architecture, and intracellular levels of podocyte-associated molecule in a diabetic milieu."

Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Metabolic Disorders • Nephrology • Renal Disease • NPHS1 • PODXL

A Multicenter Retrospective Study of Erythropoietin Combined with Low-Dose Roxadustat in the Treatment of Renal Anemia in Hemodialysis Patients (ERA 2025) - "Low-dose roxadustat combined with EPO is safe and effective for hemodialysis patients with renal anemia whose Hb levels cannot be maintained within target ranges with EPO alone."

Retrospective data • Anemia • Autosomal Dominant Polycystic Kidney Disease • Chronic Kidney Disease • Diabetic Nephropathy • Glomerulonephritis • Hematological Disorders • Lupus Nephritis • Nephrology • Polycystic Kidney Disease • Renal Disease

The Effect of an Integrated Community Nephrology Multi-Disciplinary Clinic on Patients with Chronic Kidney Disease (ERA 2025) - "MDT interventions included optimising CKD management by initiating therapies such as RAAS blockade, SGLT2 inhibitors, sodium bicarbonate, calcium supplementation, erythropoietin and roxadustat, as well as initiating advanced care planning... In this data, a virtual MDT approach resulted in a reduced rate of eGFR decline, reduction of systolic blood pressure, and improved proportion of bicarbonate measurement. This analysis demonstrates that the virtual MDT approach can facilitate improved management of renal health in patients with CKD."

Clinical • Chronic Kidney Disease • Nephrology • Renal Disease

Observational Study of the Clinical Use of Roxadustat for Treatment of Chronic Kidney Disease-Related Anaemia in Sweden: The MOROCCO study (ERA 2025) - "In Sweden, the characteristics of patients with CKD-related anaemia treated with roxadustat, and reasons for its prescription, differed by dialysis status. NDD patients were older than DD patients, had a higher prevalence of cerebrovascular diseases and lower CRP and ferritin values, and were more likely to be ESA-naïve at roxadustat initiation."

Clinical • Observational data • Anemia • Chronic Kidney Disease • CNS Disorders • Hematological Disorders • Nephrology • Renal Disease • Vascular Neurology • CRP

Responsiveness to Roxadustat in Non-dialysis Chronic Kidney Disease Patients with Anemia by Baseline Hemoglobin: A Secondary Analysis of the ROXSTAR Registry (ERA 2025) - P4 | "Roxadustat effectively corrected anemia, maintained target Hb levels, and improved iron utilization in ND-CKD patients in real-world settings, irrespective of baseline Hb levels. However, fewer patients with baseline Hb <90 g/L achieved target Hb levels despite higher roxadustat doses and iron use, highlighting the potential benefits of earlier anemia treatment initiation when Hb levels are ≥90 g/L."

Clinical • Anemia • Chronic Kidney Disease • Hematological Disorders • Nephrology • Renal Disease • CRP

Evolution Of Anemia Treatment With Hif-Ph Inhibitors In Europe (ERA 2025) - "The first hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitor, roxadustat, was approved in Europe in 2021, followed by vadadustat in 2023, marking the first new treatments for renal anemia since erythropoiesis- stimulating agents (ESAs) were introduced in 1988. The adoption of HIF-PH inhibitors for anemia treatment has been gradual, but significant opportunities exist for broader integration to enhance patient outcomes. These agents hold particular promise for treatment-naïve patients, ESA hypo-responders, and those with suboptimal responses to ESA therapy, offering a potential shift toward more effective and individualized care."

Anemia • Chronic Kidney Disease • Hematological Disorders • Inflammation • Nephrology • Renal Disease

Exploring roxadustat effect on oxidative stress: a pilot study in patients with CKD. (ERA 2025) - "To our knowledge, this is the first study in patients with CKD evaluating the effect of roxadustat on OxSt. Although not reaching statistical significance and with the limitation of a very small sample size, our results indicate a reduction of OxSt after only 3 months of roxadustat treatment and support a study on a larger cohort of patients and for a longer duration of time. If confirmed, these results might reveal new positive clinical implications of roxadustat on CKD progression and risk of cardiovascular disease of these patients."

Clinical • Oxidative stress • Anemia • Atherosclerosis • Cardiovascular • Chronic Kidney Disease • Fibrosis • Hematological Disorders • Hypertension • Immunology • Inflammation • Metabolic Disorders • Nephrology • Reperfusion Injury • Septic Shock • HIF1A • RHOA • SOD2

Prospective observational cohort study on the treatment of anemia and iron deficiency with hypoxia-inducible factor prolyl hydroxylase inhibitor in patients with CKD (ERA 2025) - "Roxadustat demonstrated significant efficacy in increasing hemoglobin levels and improving iron metabolism in ESA-naïve CKD patients over a 90-day treatment period. Hemoglobin levels rose significantly (p < 0.001), and iron parameters, including ferritin and TSAT, exhibited positive trends, highlighting enhanced erythropoiesis and reduced iron stores. These findings underscore the potential of Roxadustat as a safe and effective treatment option for managing anemia in non-dialysis CKD patients."

Clinical • Observational data • Anemia • Cardiovascular • Chronic Kidney Disease • Diabetic Nephropathy • Genetic Disorders • Glomerulonephritis • Hematological Disorders • Lupus Nephritis • Nephrology • Oncology

Responsiveness to Roxadustat in Non-dialysis Chronic Kidney Disease Patients with Anemia by Baseline Iron Status: A Secondary Analysis of the ROXSTAR Registry (ERA 2025) - P4 | "Roxadustat effectively corrected anemia and maintained target Hb levels in ND- CKD patients across all baseline iron statuses, demonstrating its utility in real-world settings. Notably, even in patients with absolute ID, roxadustat improved Hb level and iron utilization when combined with oral supplemental iron."

Clinical • Anemia • Chronic Kidney Disease • Hematological Disorders • Nephrology • Renal Disease • CRP

Roxadustat Treatment of Anaemia in Chronic Kidney Disease (CKD) in Real-World Clinical Practice: Observational Study Using Secondary Data from the QuaNT-Registry in Germany (ERA 2025) - No abstract available

Clinical • Observational data • Real-world • Real-world evidence • Anemia • Chronic Kidney Disease • Hematological Disorders • Nephrology • Renal Disease

Activated HIF-1a accelerates tubular repair in Acute kidney injury via cell proliferation (ERA 2025) - "The present study indicates that HIF-1α activation by Roxadustat treatment accelerates cell proliferation in PTECs as a part of the protective mechanism of Roxadustat on tubule damage and AKI."

Acute Kidney Injury • Anemia • Chronic Kidney Disease • Hematological Disorders • Nephrology • Renal Disease • CCNA2 • HIF1A • KIM1 • PCNA

Role of Roxadustat for Prevention of Severe Contrast-induced Acute Kidney Injury in Rats (ERA 2025) - "Pretreatment with roxadustat resulted histopathologically less severe and less frequent contrast induced acute kidney injury in rats. HIF1-alpha increased with roxadustat administration, but the protection occurs other than AIM2/CD73 pathways, which protects kidney cells from ischemic injury."

Preclinical • Acute Kidney Injury • Anemia • Chronic Kidney Disease • Fibrosis • Hematological Disorders • Immunology • Nephrology • Renal Disease • CASP3 • CD73 • HIF1A

Spotlight on roxadustat: lessons from the clinic (ERA 2025) - "Sponsored by Astellas Pharma Europe Ltd."

ISS2.13 Spotlight on roxadustat: lessons from the clinic (ERA 2025) - "Sponsored by Astellas Pharma Europe Ltd. Expert insights on the application of roxadustat in clinical practice."

A single-centre experience of Roxadustat for pre-dialysis patients (UKKW 2025) - "51 patients were prescribed Roxadustat between January 2023 and December 2024. All patients had CKD stage 4 or 5 and were pre-dialysis. The most common starting dose was 70mg three times weekly, but a significant minority of patients were started on 50mg three times weekly (full results to follow)."

Clinical • Anemia • Chronic Kidney Disease • Hematological Disorders • Inflammation • Nephrology • Renal Disease

Roxadustat: Bringing new anaemia therapies to the South West (a single unit experience). (UKKW 2025) - "With our audit showing a Hb level increase in 83% of the patients commenced on the HiF drug pathway, we are keen to be able to offer this treatment option to a wider range of patients. However, due to the South West having an ageing population there are barriers which have been identified during the audit process, which must be overcome. Key challenges include addressing the perception of 'pill burden' and exploring ways to extend this drug therapy to housebound patients."

Anemia • Chronic Kidney Disease • Hematological Disorders • Nephrology • Renal Disease

Evaluation of the efficacy of Roxadustat combined with oral iron in the treatment of renal anemia in hemodialysis patients who meet iron standards: a randomized controlled clinical study (ChiCTR) - P4 | N=48 | Not yet recruiting | Sponsor: Ya'an People's Hospital; Ya'an People's Hospital

New P4 trial • Anemia • Chronic Kidney Disease • Hematological Disorders • Nephrology • Renal Disease

HIF-2a signaling in L-cells is crucial for GLP-1 secretion in response to luminal lipids (ENDO 2025) - "This improvement in glucose tolerance is reversed when the GLP-1 receptor antagonist Exendin 9-39 is administered, confirming that L-cell HIF-2α enhances glucose homeostasis through GLP-1...We also investigated whether pharmacological activation of HIF-2α with FG-4592 affects intestinal lipid sensing and GLP-1 secretion...Mechanistically, we found that HIF-2α enhances lipid sensing in L-cells through the GPR40 receptor, leading to increased GLP-1 secretion. Thus, our study identifies a target to improve the endogenous production of GLP-1 in response to luminal nutrients, specifically lipids."

Genetic Disorders • Obesity • EPAS1 • GCG

Explore the effect of HIF-PHI on blood pressure variation rate and anemia efficacy in maintenance hemodialysis patients. (PubMed, BMC Nephrol) - "MHD patients treated with Roxadustat experienced fewer fluctuations in blood pressure compared to those treated with rHuEPO, and Roxadustat was more effective at increasing hemoglobin levels without compromising efficacy relative to ESAs."

Journal • Retrospective data • Anemia • Diabetes • Diabetic Nephropathy • Genetic Disorders • Glomerulonephritis • Hematological Disorders • Immunology • Metabolic Disorders • Nephrology • Polycystic Kidney Disease • Renal Disease • Scleroderma • Systemic Sclerosis

Long-term safety and effectiveness of roxadustat in Chinese patients with chronic kidney disease-anemia: The ROXSTAR registry. (PubMed, Chin Med J (Engl)) - P4 | "Roxadustat (52 weeks) increased hemoglobin and maintained the treatment target in Chinese patients with CKD-anemia with acceptable safety, supporting its use in real-world settings."

Journal • Anemia • Cardiovascular • Chronic Kidney Disease • Hematological Disorders • Nephrology • Renal Disease • Thrombosis