Delivery 7–10 daysVafseo (vadadustat) 300 mg tablets
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Description
💊 Prescription oral HIF prolyl hydroxylase inhibitor for anaemia of chronic kidney disease.
▪︎ Vadadustat 300 mg film-coated tablets, 60 per pack (150 mg and 450 mg strengths also exist)
▪︎ Manufacturer: Akebia Therapeutics / Otsuka
▪︎ FDA approval: March 2024, for adults on dialysis for at least three months
🔬 How it works: the body has a built-in oxygen sensor, the HIF factor, which a dedicated enzyme continuously degrades while oxygen is plentiful. Vadadustat blocks that enzyme, so the body behaves as if it had gone up a mountain and produces its own erythropoietin — rather than receiving the finished hormone by injection. Iron handling improves alongside. 📊 Evidence: INNO2VATE (NEJM 2021) in 3,923 dialysis patients — a major cardiovascular event in 18.2% versus 19.3% on darbepoetin alfa (HR 0.96, 95% CI 0.83–1.11), non-inferiority met. PRO2TECT (NEJM 2021) in 3,476 non-dialysis patients — haemoglobin non-inferiority met, but the cardiovascular hazard ratio was 1.17 (95% CI 1.01–1.36) against a pre-specified margin of 1.25, which is why the indication covers dialysis only.
⚠️ Prescription-only, started by a nephrologist. Requires monitoring of haemoglobin, ferritin and transferrin saturation; iron repletion is usually necessary because stimulating red cell production without iron achieves nothing. Haemoglobin is deliberately not normalised to healthy levels.
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