Can daprodustat be used in patients with CKD who are not on dialysis?

Daprodustat (Daprodustat) was initially considered as a potential treatment option for a wide range of patients with CKD and anemia, including those with non-dialysis CKD (ND-CKD) who have not yet entered dialysis. As research continues to deepen, more and more overseas clinical data support its use in non-dialysis patients, especially in early- and mid-stage CKD patients who are less dependent on long-term ESAs, require more flexible treatment strategies, or have difficulty maintaining regular injection courses. It has demonstrated stable and manageable safety and efficacy.

Not on dialysis CKD patients have unique challenges in anemia management, including inflammatory status, poor iron utilization, multiple concomitant medications, varying rates of disease progression, and other factors, which often affect the effectiveness of ESA. The mechanism of daprostat is endogenous redness regulation, which is closer to the body's natural response to hypoxia, which enables it to provide a relatively gentle and sustained hemoglobin increasing trend in people without dialysis. Overseas studies have shown that it can also maintain stable hemoglobin levels in non-dialysis CKD patients and is generally well tolerated, providing a feasible long-term treatment option for these early- to mid-stage patients.

Not on dialysis The management of anemia in CKD places greater emphasis on convenience, and the oral advantages of daprostat meet this need. Many non-dialysis patients do not yet have dialysis access, so the need for frequent ESA injections is often burdensome for them and may reduce compliance. Oral Daprodustat allows patients to take it regularly at home without relying on injection arrangements from medical institutions, making management more life-like and sustainable.

In terms of iron metabolism management, non-dialysis Iron absorption in CKD patients is often affected by factors such as chronic inflammation, changes in gastrointestinal function, dietary restrictions, etc. The iron mobilization effect of HIF-PHI can improve iron utilization efficiency, reduce dependence on intravenous iron, and make anemia treatment more stable. For patients with good gastrointestinal tolerance, dapoxostat allows anemia management to occur in a more natural way.

Reference materials:https://en.wikipedia.org/wiki/Daprodustat