Characteristics and management of patients with renal anaemia treated with daprodustat: an observational study in Japan.

Objective: HIF-PHI inhibitors, including daprodustat, have expanded treatment options for patients with renal anaemia in Japan. This analysis examines real-world utilization of daprodustat in Japan, for which data are currently lacking.

Methods: This retrospective cohort study analyzed patient characteristics, treatment patterns, and management of renal anaemia in individuals aged >15 years who were treated with daprodustat between 1 August 2020 and 1 July 2023 using an anonymized electronic medical record database. Patients were assigned to dialysis-dependent (DD) and nondialysis-dependent (ND) cohorts.

Results: This study included 1299 patients (111 DD cohort; 1188 ND cohort). Mean age was 71.0 and 79.2 years in the DD and ND cohorts, respectively. In both cohorts, hypertension, heart failure, oesophageal gastric erosion, and type 2 diabetes mellitus were frequent comorbidities. In the DD cohort, 31.5% of patients had Hb levels of 9-10 g/dL at baseline and in the ND cohort 35.9% had Hb levels <9 g/dL at baseline. Prior to the index date, 72 patients in the DD cohort (64.9%) and 635 patients (53.5%) in the ND cohort were treated for anaemia. In patients who switched from erythropoiesis-stimulating agents to daprodustat, mean haemoglobin increased from 9.9 g/dL at baseline to 10.8 g/dL in the DD cohort (n = 23; Wilcoxon sign-ranked test [WSRT] p = 0.0148) and from 9.6 g/dL at baseline to 10.4 g/dL in the ND cohort (n = 92; WSRT p < 0.0001) 28 weeks after daprodustat initiation.

Conclusion: Approximately a third (DD) to almost half (ND) of patients with renal anaemia were not receiving treatment for anaemia. An increase in haemoglobin levels was observed after initiation of daprodustat, including in patients previously treated with erythropoiesis-stimulating agents, however causality cannot be confirmed due to lack of a control group.