Factors that affect the response to vadadustat in those with anemia associated with chronic kidney disease

A new study has found several factors that impact the effectiveness of vadadustat. These insights could assist in making informed decisions about dose adjustments for the drug. This study’s findings were presented in the journal Clinical and Experimental Nephrology.

The studies on non-dialysis-dependent chronic kidney disease (NDD-CKD) and hemodialysis-dependent chronic kidney disease (HDD-CKD) began with 151 and 162 patients, respectively. Finally, 136 and 140 patients were included and divided into subgroups for analysis. The resistance index for assessing vadadustat responsiveness was defined as the mean body weight-adjusted dose of vadadustat (mg/kg) at weeks 20 to 24, divided by the mean hemoglobin level (g/dL) during the same period. To investigate the factors that affect the resistance index, a multivariate analysis was conducted.

Factors that were independently linked to a better response to vadadustat included: low baseline eGFR, high baseline hemoglobin, elevated ferritin levels between weeks 20-24, and chronic kidney disease not due to glomerulonephritis, autoimmune diseases, or vasculitis in non-dialysis-dependent chronic kidney disease. In the case of dialysis-dependent chronic kidney disease, the determinants were male sex, a low erythropoiesis-stimulating agent resistance index (ERI), and high baseline C-reactive protein.

The study highlighted several factors influencing the effectiveness of vadadustat in patients with NDD-CKD, including low baseline eGFR, high baseline hemoglobin, elevated ferritin levels, and the presence of chronic kidney disease not linked to glomerulonephritis, autoimmune diseases, or vasculitis. When considering HDD-CKD, factors like a low erythropoiesis-stimulating agent resistance index (ERI), being male, and high baseline C-reactive protein influenced the efficacy of vadadustat. Understanding these factors can help guide appropriate dose adjustments for vadadustat.