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Dialyse aktuell 2022; 26(10): 453-459
DOI: 10.1055/a-1924-3492
Schwerpunkt
Nephrologie

HIF-PH-Inhibitoren in der Therapie der renalen Anämie

Alternative zu Erythropoetin-Stimulanzien
Bernd Schröppel
1   Klinik für Innere Medizin I, Sektion Nephrologie, Universitätsklinikum Ulm
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ZUSAMMENFASSUNG

Die bisherige Standardbehandlung der renalen Anämie umfasst die Sicherstellung ausreichender Eisenspeicher und die Verabreichung von Erythropoetin-Stimulanzien (ESA). Eine medikamentöse Alternative zu ESA sind nun Wirkstoffe, die HIF-PH (HIF: Hypoxie induzierbarer Faktor; PH: Prolylhydroxylasen) inhibieren. Denn Prolylhydroxylasen vermitteln den sauerstoffabhängigen Abbau von HIF und regulieren so die zelluläre Antwort auf Hypoxie in der Anämie und eine Reihe anderer chronischer Erkrankungen. HIF-PH-Inibitoren (HIF-PHI) sind eine neue Klasse oraler Medikamente, die HIF aktivieren und durch mehrere Mechanismen die Erythropoese steigern. HIF-PHI erhöhen nicht nur die Produktion von Erythropoetin und optimieren den Eisenmetabolismus, sondern besitzen durch die Vielzahl an HIF-regulierten Genen weitere zielgerichtete Wirkungen. Basierend auf den Daten zur Korrektur der renalen Anämie und zur Sicherheit bei dialysepflichtigen und nichtdialysepflichtigen Patienten mit chronischer Nierenerkrankung (CKD: „chronic kidney disease“) ist diese neue Wirkstoffklasse eine Alternative zu ESA. Die Europäische Arzneimittel-Agentur (EMA) hat Roxadustat im August 2021 für die klinische Anwendung in der Europäischen Union zugelassen.



Publication History

Article published online:
12 December 2022

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