Alternative anaemia treatment approved thanks to patient input
A new treatment to treat anaemia in dialysis patients has been approved by the National Institute for Health and Care Excellence (NICE) after input from people with kidney disease and clinical experts into the decision-making process. The final draft guidance means that people over the age of 18 with anaemia who are undergoing dialysis will have access to vadadustat, an oral alternative to treating anaemia with erythropoiesis-stimulating agents (ESAs).
What is vadadustat?
Vadadustat is from a new class of drug called HIF-PH inhibitors. It stimulates the production of erythropoietin (EPO), a hormone that regulates the production of red blood cells and impacts the supply of oxygen to the body. In people with chronic kidney disease, the production of EPO is inhibited. By stimulating the production of EPO, more red blood cells are produced, increasing the blood’s capacity to carry oxygen around the body, which may reduce the symptoms of anaemia. Vadadustat works by inhibiting a substance called hypoxia-inducible prolyl-hydroxylase (HIF-PH), hence the name of the class of drug. It is available in tablet form and taken orally once a day.
What effect will this recommendation have on patients?
This decision increases the treatment options for people receiving dialysis with anaemia. There are some limitations to using ESAs, which have been the current treatment option until now. ESAs are not suitable for people with red cell aplasia (a rare type of anaemia) or those with uncontrolled or poorly controlled high blood pressure, and some people are resistant to treatment with ESAs.
Kidney patient Fez Awan has been affected by anaemia on many occasions and shared his experiences during the NICE consultation process. He said: “I have been hampered with lack of energy, breathlessness concentration and focus issues. This has made me adapt many times to try and focus and carry on my day-to-day life.
“This new decision gives others hope to potentially navigate and manage anaemia for them to live with the best possible quality of life.”
A welcome decision
Alison Railton, head of policy and external affairs at Kidney Research UK, said: “We welcome the decision from NICE to recommend vadadustat as part of a new approach to treating anaemia in people with chronic kidney disease and receiving dialysis. Anaemia can be debilitating and seriously impact quality of life in people with kidney disease.
“This news comes six years after the results of our PIVOTAL trial which determined the optimum amount of iron to give people on haemodialysis with anaemia. We’re pleased research in this area has continued to move forward and that treatment options are expanding. We’d like to thank those people with first-hand experience of the disease, who assisted with our contribution to the NICE decision-making process, ensuring the patient voice was heard and understood.”
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