Difference in Therapeutic Effects between Roxadustat and Daprodustat, HIF-Ph Inhibitors, Depending on the Blood Type in Hemodialysis (HD) Patients

Abstract

Human blood group antigens are glycoproteins and glycolipids expressed on the surface of red blood cells and a variety of human tissues. This study aimed to determine if there is an association between ABO blood type and the efficacy of HIF-PH inhibitors. Roxadustat and daprodustat are potent inhibitors of HIF-PH and capable of stimulating erythropoiesis in patients on patients with impaired renal function. These two compounds are reported to act mechanistically similar but display differences in their effects on cells, and the differences may affect their efficacy in the treatment of renal anemia in HD patients. In this study we compared the response rate by blood type between roxadustat and daprodustat, respectively.Sixty-eight HD patients treated with roxadustat (20-100mg, 3/week) and ninety-five treated with daprodustat (1-12mg, daily) were recruited in our observational study. We defined >1.5g/dL increase in hemoglobin as effective, and <1.5g/dL decrease as ineffective.As shown in the figure, type A had a significantly high response rate at 47% in HD patients treated with roxadustat. On the other hand, type O had a significantly high response rate at 55% in those who were treated with daprodustat.We found the association in the effectiveness of roxadustat on the treatment for anemia in HD patients in type A, while the effectiveness was higher in type O treated with daprodustat. The results suggest that the therapeutic effect of HIF-PH inhibitors may differ depending on the blood type. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.