New treatment recommended for kidney patients with anaemia

21 June 2022

The National Institute for Health and Care Excellence (NICE) has recommended roxadustat for the treatment of anaemia in adult chronic kidney disease (CKD) patients. The new first of its kind medication (brand name Evrenzo) will offer a simplified and more tolerable treatment. The exciting development can be traced back to original work by a former Kidney Research UK, Nobel-prize winning researcher.

What is CKD-associated anaemia?

Anaemia is a serious medical condition, in which patients have insufficient red blood cells and low levels of haemoglobin, which can cause debilitating fatigue and other symptoms. It is a common early complication of CKD affecting an estimated 75,000 adults in England and Wales.

The kidneys help to regulate the production of red blood cells with a hormone called erythropoietin (EPO). The damage to the kidneys caused by CKD can disrupt this process and inhibit the production of new red blood cells.

What is roxadustat?

The new treatment mimics the body’s natural response to low oxygen levels within the blood (a state known as hypoxia) and stimulates the body to increase the production of red blood cells. It is taken as an oral tablet.

The recent guidance now allows for roxadustat to be considered as an option for CKD patients who are not receiving dialysis treatment. As the medicine is taken as a tablet this should simplify the treatment of CKD-associated anaemia and reduce the need for intravenous iron and EPO injections under the skin.

What does this mean for CKD patients?

Current treatments for CKD associated anaemia include iron given intravenously and orally, and a class of medications known as erythropoiesis stimulating agents (ESAs) which stimulate the bone marrow to produce red blood cells. ESAs are given by injection into the vein (for patients on haemodialysis) or subcutaneously (under the skin).

As an oral treatment roxadustat could result in fewer hospital visits for patients, who can take this treatment alongside their other medications.

Based on Nobel Prize-winning science

The development of this new treatment was influenced by Nobel Prize winning science. Former Kidney Research UK trustee and leading nephrologist Professor Sir Peter Ratcliffe received the prestigious joint award with for his work discovering how cells sense and adapt to oxygen levels. In the 1990s the charity funded an early project led by Sir Peter into the production of the hormone erythropoietin which later led to his major discovery.

Professor Liz Lightstone, Kidney Research UK trustee and professor of renal medicine at Imperial College London said: “Invasive treatments and excessive hospital trips are not uncommon for kidney patients as a large proportion of their lives are spent managing their kidney disease. This treatment gives patients more choice and the chance of an improved quality of life.

“Sir Peter’s work highlights the importance of funding research aimed at unravelling key biological processes so that more effective treatments can be developed. This development is a prime example of rational targeted therapy based on outstanding basic science in which Kidney Research UK has had an important role.”