Clinical efficacy and safety analysis in initial hemodialysis patient with renal anemia treated by roxadustat or recombinant human erythropoietin

Objective To compare the clinical efficacy and safety of roxadustat versus recombinant human erythropoietin(rhEPO)for renal anemia in initial hemodialysis patients. Methods From January 2020 to June 2021, retrospective analysis was performed for 107 patients with renal anemia on hemodialysis.They were assigned to two groups of roxadustat(n=57)and rhEPO(n=50).Both groups received polyferose, methycobal and folic acid. For comparing the clinical efficacy and safety of two groups, the changes of red blood cell(RBC), hemoglobin(Hb), hematocrit(Hct), erythropoietin (EPO), serum ferrin(SF), transferrin(TRF), transferrin saturation(TSAT), hepcidin(HePc), white blood cell(WBC), inflammatory factor including C-reactive protein(CRP)and interleukin-6(IL-6)were recorded at Month 1/3/6 post-treatment. The incidences of side effects within 6 months were analyzed. Results At the beginning, no significant inter-group differences existed in RBC, Hb, HCT, EPO, SF, TRF, TSAT, HEPC, WBC, CRP or IL-6(P>0.05). After 1-month treatment, RBC, Hb, HCT, EPO, SF, TRF and TSAT spiked while HePc declined in two groups(P<0.05). After 3/6-month treatment, RBC, Hb, HCT, EPO, SF, TRF and TSAT in two groups were higher than those at the beginning and there were significant inter-group differences(P<0.05);RBC, Hb, Hct, SF and TRF were higher in roxadustat group than in erythropoietin group(P<0.05). However, EPO was lower and TSAT showed no significant inter-group difference(P>0.05). HePc dropped further in both groups and decrease of HePc was more marked in roxadustat group than that in rythropoietin group(P<0.05). After 1-month treatment, CRP and IL-6 declined in roxadustat group and the values varied markedly from previously(P<0.05). The changes were slight at Month 3/6(P>0.05)while CRP and IL-6 had no significant change in erythropoietin group at Month 1/3/6(P>0.05)and there were significant inter-group differences(P<0.05). WBC had no obvious changes at Month 6(P>0.05)and there was no significant inter-group difference(P>0.05). The incidence of adverse reactions showed no significant inter-group difference(P>0.05). Conclusion As compared with rhEPO, roxadustat offers a better clinical efficacy for patients with renal anemia on initial hemodialysis. It can more effectively and safely improve renal anemia, modulate iron metabolism and lower the level of inflammatory factors.