Table 3 Comparison of HIF-PHI and ESA drug dosagesa
Study | Interventions | Weight (kg)2 | Dosage | Hemoglobin | Conclusion | ||
|---|---|---|---|---|---|---|---|
CRP < ULN | CRP ≥ ULN | CRP < ULN | CRP ≥ ULN | ||||
Akizawa et al. 2020 [18] | Roxadustat | 57.82 (11.97) | Baseline: 70 mg TIW | Baseline: 85 mg TIW | Baseline: 11 g/dL | Baseline: 10.9 g/L | Roxadustat dosage decreased over time and didn’t affect by CRP levels, whereas in an inflammatory state, Darbepoetin Alfa dosage increased over time, indicating ESA resistance. Roxadustat at 70 mg TIW is equivalent to Darbepoetin Alfa < 20ug/wc, in the CRP ≥ ULN group, ESA dosage is higher than roxadustat dosage during follow up |
During follow up: Consistently at 70 mg TIW before the 14th week, and declined to 50 mg TIW after the 14th week | During follow up: Increased to 100 mg TIW during the 1st and 4th to 7th weeks, decreased to 70 mg TIW after the 8th week, and then decreased to 50 mg TIW during the 13th and 20th to 23rd weeks | During follow up: Increased to 11.2 g/dL during the 1st to 4th weeks, fluctuated around 11 g/dL during the 6th to 24th weeks, mean ∆Hb18-24wb -0.03(0.79)g/dL | During follow up: Increased to 11.3 g/dL during the 1st to 6th weeks, gradually decreased to 11 g/dL during the 7th to 16th weeks, mean ∆Hb18-24wb -0.13 (0.81)g/dL | ||||
Darbepoetin Alfa | 58.78 (12.90) | Baseline: 15ug/w | Baseline: 20 ug/w | Baseline: 11.1Â g/dL | Baseline: 11.1Â g/dL | ||
During follow up: increased to 20 ug/w during the 4th to 18th weeks, declined to 15 ug/w after the 18th week | During follow up: Increased to 30ug/w after the 11th week | During follow up: Fluctuated around 11 g/dL, with slight decreasing trend, mean ∆Hbb -0.03 (0.88) g/dL | During follow up: Fluctuated around 11 g/dL, with slight decreasing trend, mean ∆Hbb -0.18 (0.94) g/dL | ||||
Provenzano et al. 2021 [16] | Roxadustat | 76.0 (18.5) | Baseline: 3.7 mg/kg/w | Baseline: 3.5 mg/kg/w | Baseline: 8.4 (1.0) g/dLb | Baseline: 8.4 (1.0) g/dLb | There was little difference in roxadustat drug dosage across different CRP groups, whereas the maximum Epoetin alfa drug dose was 30 IU/kg/w greater in the CRP ≥ ULN group than in the CRP < ULN group. Based on mean body weight, the roxadustat dose was less than 100 mg TIW and the Epoetin alfa dose was 76,700 IU/w. The two doses were in the same intervald, but roxadustat was closer to the lower limit of the interval and Epoetin alfa was closer to the upper limit of the interval |
During follow up: Gradually declined to 3 mg/kg/w at the 40th week | During follow up: Gradually declined to 3 mg/kg/w at the 44th week | During follow up: Mean ∆Hb increased to 2.6 g/dL from baseline to the 8th week, then fluctuated from 2.5 g/dL to 3 g/dL | During follow up: Mean ∆Hb increased to 2.4 g/dL from baseline to the 12th week, then fluctuated from 2.2 g/dL to 2.6 g/dL | ||||
Epoetin alfa | 76.7 (19.1) | Baseline: 130Â IU/kg/w | Baseline: 140Â IU/kg/w | Baseline: 8.4 (1.0) g/dLb | Baseline: 8.4 (1.0) g/dLb | ||
During follow up: Declined over time, fluctuated from 105 IU/kg/w to 130 IU/kg/w during the 8th to 52nd weeks | During follow up: Increased to 150 IU/kg/w at the 6th week, then decreased to 120 IU/kg/w at the 24th week, then fluctuated from 110 IU/kg/w to 130 IU/kg/w | During follow up: Mean ∆Hb increased to 2.6 g/dL from baseline to the 12th week, then fluctuated from 2.2 g/dL to 2.6 g/dL | During follow up: Mean ∆Hb increased to 2.6 g/dL from baseline to the 22nd week, then fluctuated from 2.4 g/dL to 2.6 g/dL | ||||
Charytan et al. 2021 [17] | Roxadustat | 84.3 (22.3) | Baseline: 4.4 mg/kg/w | Baseline: 4 mg/kg/w | Baseline: 10.30 (0.66) g/dLb | Baseline: 10.30 (0.66) g/dLb | Roxadustat dose remained stable during the follow up and was lower in the CRP ≥ ULN group than in the CRP < ULN group, while Epoetin alfa dose increased over time, indicating ESA resistance, with a more pronounced effect in inflammatory conditions. Calculated based on average weight, the roxadustat dosage is approximately 110 mg TIW, whereas the Epoetin alfa dosage is 86,600 IU/w. The ESA dosage is higher than that of roxadustatc |
During follow up: Remained stable, fluctuated from 4 mg/kg/w to 4.4 mg/kg/w | During follow up: Remained stable, fluctuated from 3.8 mg/kg/w to 4 mg/kg/w | During follow up: Mean ∆Hb increased to 0.75 g/dL from baseline to the 8th week, then gradually decreased to 0.1 g/dL at 48th week | During follow up: Mean ∆Hb increased to 0.8 g/dL from baseline to the 6th week, then gradually decreased to 0.4 g/dL at 48th week | ||||
Epoetin alfa | 86.6 (23.0) | Baseline: 95Â IU/kg/w | Baseline: 100Â IU/kg/w | Baseline: 10.31 (0.66) g/dLb | Baseline: 10.31 (0.66) g/dLb | ||
During follow up: Decreased to 80 IU/kg/w at the 6th week, then increased to 120 IU/kg/w at 44th week | During follow up: Gradually increased to 180 IU/kg/w at 48th week | During follow up: Mean ∆Hb increased to 0.2 g/dL at 1st week, decreased to -0.1 g/dL at 14th week, fluctuated from 0 g/dL to -0.2 g/dL during the 14th to 52nd weeks | During follow up: Mean ∆Hb fluctuated from 0.1 g/dL to -0.2 g/dL | ||||