Abstract:
INTRODUCTION:In the last decade, concerns have been raised around the use of erythropoiesis-stimulating agents (ESAs) and intravenous iron in chronic kidney disease (CKD) patients, especially when given at high doses. Moreover, treatment with ESA is expensive. AREAS COVERED:We searched PubMed for original articles, reviews, and editorials having as a topic anemia, CKD, hypoxia inducible factor, hepcidin, iron, and hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHI). HIF-PHI are a new class of small molecules activating HIF-alfa isoforms (the main mediators of the effects of hypoxia on the body). This causes the secretion of endogenous erythropoietin and increased iron availability. Differing from ESA, HIF-PHI are administered orally. Preliminary data from phase-II clinical studies have shown their efficacy and safety in the short term. EXPERT OPINION:HIF-PHI are a new promising class of drugs. The results of large, phase-III clinical studies are awaited to prove their efficacy and safety on cardiovascular events and cancer development in the long term. Their capability of penetrating the ESA market in the future will be influenced also by their selling price. The oral administration of HIF-PHI will be weighed to the 'intra-lines' infusion of ESA in hemodialysis or to the infrequent subcutaneous injections of long-acting ESA.
journal_name
Expert Opin Investig Drugsjournal_title
Expert opinion on investigational drugsauthors
Del Vecchio L,Locatelli Fdoi
10.1080/13543784.2018.1493455subject
Has Abstractpub_date
2018-07-01 00:00:00pages
613-621issue
7eissn
1354-3784issn
1744-7658journal_volume
27pub_type
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journal_title:Expert opinion on investigational drugs
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