Literature DB >> 31117088

Enarodustat, Conversion and Maintenance Therapy for Anemia in Hemodialysis Patients: A Randomized, Placebo-Controlled Phase 2b Trial Followed by Long-Term Trial.

Tadao Akizawa1, Masaomi Nangaku2, Takuhiro Yamaguchi3, Masanobu Arai4, Ryosuke Koretomo4, Kazuo Maeda4, Yuya Miyazawa4, Hideki Hirakata5.   

Abstract

BACKGROUND: Enarodustat (JTZ-951) is an orally available hypoxia-inducible factor prolyl hydroxylase inhibitor that increases endogenous erythropoietin levels in the treatment of anemia associated with chronic kidney disease (CKD).
OBJECTIVE: A phase 2b study of enarodustat to assess the hemoglobin (Hb) response, safety, and maintenance dosage was conducted in Japanese anemic patients with hemodialysis-dependent CKD.
METHODS: Subjects receiving a stable dose of an erythropoiesis-stimulating agent were randomized to receive once-daily enarodustat at a dose of 2, 4, or 6 mg or placebo in a double-blind manner for 6 weeks (Period 1) followed by 24-week open treatment with enarodustat, adjusted in the range of 2-8 mg to maintain Hb within a target range (10.0-12.0 g/dL; Period 2).
RESULTS: Change in Hb from baseline increased with enarodustat dose in Period 1. In Period 2, the proportion of subjects who maintained their Hb level within the target range at the end of treatment was 65.1%. To maintain Hb levels within the target range over the course of Period 2, approximately 80% of subjects required 2 dose adjustments or fewer. Enarodustat decreased hepcidin and ferritin levels, increased total iron-binding capacity, and was generally well tolerated.
CONCLUSIONS: Enarodustat corrected and maintained Hb levels in anemic patients with hemodialysis-dependent CKD. Phase 3 studies of enarodustat are currently ongoing.
© 2019 The Author(s) Published by S. Karger AG, Basel.

Entities:  

Keywords:  Anemia in chronic kidney disease; Enarodustat; Hepcidin; Hypoxia-inducible factor prolyl hydroxylase inhibitor; Randomized trial

Mesh:

Substances:

Year:  2019        PMID: 31117088      PMCID: PMC6878752          DOI: 10.1159/000500487

Source DB:  PubMed          Journal:  Nephron        ISSN: 1660-8151            Impact factor:   2.847


  32 in total

1.  Associations between changes in hemoglobin and administered erythropoiesis-stimulating agent and survival in hemodialysis patients.

Authors:  Deborah L Regidor; Joel D Kopple; Csaba P Kovesdy; Ryan D Kilpatrick; Charles J McAllister; Jason Aronovitz; Sander Greenland; Kamyar Kalantar-Zadeh
Journal:  J Am Soc Nephrol       Date:  2006-04       Impact factor: 10.121

2.  Disappearance of association in diabetic patients on hemodialysis between anemia and mortality risk: the Japan dialysis outcomes and practice pattern study.

Authors:  Masaaki Inaba; Yasuaki Hayashino; Tetsuo Shoji; Takashi Akiba; Tadao Akizawa; Akira Saito; Kiyoshi Kurokawa; Shunichi Fukuhara
Journal:  Nephron Clin Pract       Date:  2012-02-22

3.  Angiogenic Factors and Cytokines in Diabetic Retinopathy.

Authors:  Steven F Abcouwer
Journal:  J Clin Cell Immunol       Date:  2013

4.  Hypoxia regulates vascular endothelial growth factor gene expression in endothelial cells. Identification of a 5' enhancer.

Authors:  Y Liu; S R Cox; T Morita; S Kourembanas
Journal:  Circ Res       Date:  1995-09       Impact factor: 17.367

Review 5.  The ESA scenario gets complex: from biosimilar epoetins to activin traps.

Authors:  Wolfgang Jelkmann
Journal:  Nephrol Dial Transplant       Date:  2014-04-19       Impact factor: 5.992

6.  Serum erythropoietin concentrations and responses to anaemia in patients with or without chronic kidney disease.

Authors:  Ferruh Artunc; Teut Risler
Journal:  Nephrol Dial Transplant       Date:  2007-06-07       Impact factor: 5.992

7.  Regulation of adult erythropoiesis by prolyl hydroxylase domain proteins.

Authors:  Kotaro Takeda; Hector L Aguila; Nehal S Parikh; Xiping Li; Katie Lamothe; Li-Juan Duan; Hiromi Takeda; Frank S Lee; Guo-Hua Fong
Journal:  Blood       Date:  2007-12-04       Impact factor: 22.113

8.  Cardiovascular toxicity of epoetin-alfa in patients with chronic kidney disease.

Authors:  Peter A McCullough; Huiman X Barnhart; Jula K Inrig; Donal Reddan; Shelly Sapp; Uptal D Patel; Ajay K Singh; Lynda A Szczech; Robert M Califf
Journal:  Am J Nephrol       Date:  2013-05-25       Impact factor: 3.754

9.  Intravenous ferric chloride hexahydrate supplementation induced endothelial dysfunction and increased cardiovascular risk among hemodialysis patients.

Authors:  Ko-Lin Kuo; Szu-Chun Hung; Yao-Ping Lin; Ching-Fang Tang; Tzong-Shyuan Lee; Chih-Pei Lin; Der-Cherng Tarng
Journal:  PLoS One       Date:  2012-12-05       Impact factor: 3.240

10.  Identification of erythroferrone as an erythroid regulator of iron metabolism.

Authors:  Léon Kautz; Grace Jung; Erika V Valore; Stefano Rivella; Elizabeta Nemeth; Tomas Ganz
Journal:  Nat Genet       Date:  2014-06-01       Impact factor: 38.330

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  11 in total

Review 1.  Effectiveness of hypoxia-induced factor prolyl hydroxylase inhibitor for managing anemia in chronic kidney disease: a systematic review and meta-analysis.

Authors:  Min Li; Jiarong Lan; Feixia Dong; Peixin Duan
Journal:  Eur J Clin Pharmacol       Date:  2020-11-07       Impact factor: 2.953

2.  Hypoxia-inducible factor-prolyl hydroxylase inhibitors in the treatment of anemia of chronic kidney disease.

Authors:  Volker H Haase
Journal:  Kidney Int Suppl (2011)       Date:  2021-03-18

3.  A Phase 3 Study of Enarodustat (JTZ-951) in Japanese Hemodialysis Patients for Treatment of Anemia in Chronic Kidney Disease: SYMPHONY HD Study.

Authors:  Tadao Akizawa; Masaomi Nangaku; Takuhiro Yamaguchi; Ryosuke Koretomo; Kazuo Maeda; Yuya Miyazawa; Hideki Hirakata
Journal:  Kidney Dis (Basel)       Date:  2021-07-05

Review 4.  Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease.

Authors:  Patrizia Natale; Suetonia C Palmer; Allison Jaure; Elisabeth M Hodson; Marinella Ruospo; Tess E Cooper; Deirdre Hahn; Valeria M Saglimbene; Jonathan C Craig; Giovanni Fm Strippoli
Journal:  Cochrane Database Syst Rev       Date:  2022-08-25

5.  Two long-term phase 3 studies of enarodustat (JTZ-951) in Japanese anemic patients with chronic kidney disease not on dialysis or on maintenance hemodialysis: SYMPHONY ND-Long and HD-Long studies.

Authors:  Tadao Akizawa; Masaomi Nangaku; Takuhiro Yamaguchi; Ryosuke Koretomo; Kazuo Maeda; Osamu Yamada; Hideki Hirakata
Journal:  Ther Apher Dial       Date:  2021-09-02       Impact factor: 2.195

Review 6.  Challenging patient phenotypes in the management of anaemia of chronic kidney disease.

Authors:  Sheena Pramod; David S Goldfarb
Journal:  Int J Clin Pract       Date:  2021-08-12       Impact factor: 3.149

Review 7.  Burden of Anemia in Chronic Kidney Disease: Beyond Erythropoietin.

Authors:  Ramy M Hanna; Elani Streja; Kamyar Kalantar-Zadeh
Journal:  Adv Ther       Date:  2020-10-29       Impact factor: 3.845

8.  Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients.

Authors:  Bin Wang; Qing Yin; Yu-Chen Han; Min Wu; Zuo-Lin Li; Yan Tu; Le-Ting Zhou; Qing Wei; Hong Liu; Ri-Ning Tang; Jing-Yuan Cao; Lin-Li Lv; Bi-Cheng Liu
Journal:  Ren Fail       Date:  2020-11       Impact factor: 2.606

9.  A distinctive distribution of hypoxia-inducible factor-1α in cultured renal tubular cells with hypoperfusion simulated by coverslip placement.

Authors:  Tomoko Honda; Yosuke Hirakawa; Kiichi Mizukami; Toshitada Yoshihara; Tetsuhiro Tanaka; Seiji Tobita; Masaomi Nangaku
Journal:  Physiol Rep       Date:  2021-01

10.  A Phase 3 Study of Enarodustat in Anemic Patients with CKD not Requiring Dialysis: The SYMPHONY ND Study.

Authors:  Tadao Akizawa; Masaomi Nangaku; Takuhiro Yamaguchi; Ryosuke Koretomo; Kazuo Maeda; Yuya Miyazawa; Hideki Hirakata
Journal:  Kidney Int Rep       Date:  2021-05-12
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