Credit: Original article published here.
Management of patients with anemia of chronic kidney disease (CKD) seeks to reduce red blood cell transfusions and avoid complications such as allosensitization. Researchers, led by Vivekanand Jha, MBBS, MD, DM, PhD, conducted an analysis of data on red blood cell transfusion needs in patients with CKD on and not on dialysis in the ASCEND-D and ASCEND-ND trials. Trial participants were treated with daprodustat, a novel hypoxia inducible factor prolyl hydroxylase inhibitor, or with erythropoiesis-stimulating agents (ESAs).
Results were reported during a poster session at the National Kidney Foundation Spring Clinical Meetings 2023. The poster was titled The Effects of Daprodustat on Blood Transfusion Rates in the ASCEND-D and -ND Trials.
The analysis included data on rates of red blood cell transfusions (events per 100 patient-years) in the ASCEND-D and ASCEND-ND trials and in the ASCEND-D ESA hyporesponder (ESA-HR) subgroup (baseline ESA-resistance index >2.0/>450 U/kg epoetin per week). In prespecified analyses, adjustments in Cox proportional model-estimated hazard ratios (HR) included treatment/region, dialysis type in ASCEND-D participants, and randomization-ESA use in ASCEND-ND trial participants.
In both trials, red blood cell transfusions (≥5%) and overall red blood cell transfusion rates were numerically lower in patients in the daprodustat group than in patients in the ESA group. During the evaluation period, there was no difference in time to first red blood cell transfusion for daprodustat versus ESA in ASCEND-D (HR, 0.86; 95% CI, 0.72-1.02; 1-sided P value, 0.043) or ASCEND-ND (HR, 0.96; 95% CI, 0.81-1.14; 1-sided P value, 0.32). In the ESA-HR subgroup, more participants in the daprodustat group (n=16/183; 9%) than in the ESA group (n=7/180; 4%) had red blood cell transfusions (event rates per 100 patient-years: 39.7 vs 21.4, respectively).
In conclusion, the researchers said, “For daprodustat versus ESA during the evaluation period, few patients received red blood cell transfusions and red blood cell transfusion rates and time to first red blood cell transfusion were similar in ASCEND-D and -ND, and ESA-HRs in ASCEND-D had more red blood cell transfusions.”
Source: Jha V, Johansen K, Mallett S, et al. The effects of daprodustat on blood transfusion rates in the ASCEND-D and -ND trials. Poster #183. Abstract of a poster presented during the National Kidney Foundation Spring Clinical Meetings 2023; April 11-15, 2023; Austin, Texas.
