Effects of Molidustat in the Treatment of Anemia in CKD
| Autor: | Thilo Krueger, Thomas Bernhardt, Jeffrey S. Berns, Tadao Akizawa, Iain C. Macdougall |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Transplantation
medicine.medical_specialty Darbepoetin alfa Epidemiology business.industry Anemia 030232 urology & nephrology Epoetin alfa 030204 cardiovascular system & hematology Hypoxia (medical) Critical Care and Intensive Care Medicine medicine.disease Gastroenterology 03 medical and health sciences 0302 clinical medicine Nephrology Erythropoietin Internal medicine Clinical endpoint Medicine Hemoglobin medicine.symptom business Adverse effect medicine.drug |
| Zdroj: | Clinical Journal of the American Society of Nephrology. 14:28-39 |
| ISSN: | 1555-905X 1555-9041 |
| DOI: | 10.2215/cjn.02510218 |
| Popis: | Background and objectives The efficacy and safety of molidustat, a hypoxia-inducible factor-prolyl hydroxylase inhibitor, have been evaluated in three 16-week, phase 2b studies in patients with CKD and anemia who are not on dialysis (DaIly orAL treatment increasing endOGenoUs Erythropoietin [DIALOGUE] 1 and 2) and in those who are on dialysis (DIALOGUE 4). Design, setting, participants, & measurements DIALOGUE 1 was a placebo-controlled, fixed-dose trial (25, 50, and 75 mg once daily; 25 and 50 mg twice daily). DIALOGUE 2 and 4 were open-label, variable-dose trials, in which treatment was switched from darbepoetin (DIAGLOGUE 2) or epoetin (DIALOGUE 4) to molidustat or continued with the original agents. Starting molidustat ranged between 25–75 and 25–150 mg daily in DIAGLOGUE 2 and 4, respectively, and could be titrated to maintain hemoglobin levels within predefined target ranges. The primary end point was the change in hemoglobin level between baseline and the mean value from the last 4 weeks of the treatment period. Results In DIAGLOGUE 1 ( n =121), molidustat treatment was associated with estimated increases in mean hemoglobin levels of 1.4–2.0 g/dl. In DIAGLOGUE 2 ( n =124), hemoglobin levels were maintained within the target range after switching to molidustat, with an estimated difference in mean change in hemoglobin levels between molidustat and darbepoetin treatments of up to 0.6 g/dl. In DIAGLOGUE 4 ( n =199), hemoglobin levels were maintained within the target range after switching to molidustat 75 and 150 mg, with estimated differences in mean change between molidustat and epoetin treatment of −0.1 and 0.4 g/dl. Molidustat was generally well tolerated, and most adverse events were mild or moderate in severity. Conclusions The overall phase 2 efficacy and safety profile of molidustat in patients with CKD and anemia enables the progression of its development into phase 3. |
| Databáze: | OpenAIRE |
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