Article
Author: Zhang, Aihua ; Zhu, Qiang ; Yang, Lin ; Zhang, Wenmei ; Li, Yinhui ; Xu, Qingdong ; Wan, Xiuxian ; Wu, Henglan ; Shi, Yongjun ; Chen, Qingping ; Li, Xiaowen ; Peng, Jiaqing ; Liu, Bing ; Shen, Yulan ; Chang, Wenxiu ; Zuo, Li ; Ou, Jihong ; Yang, Aicheng ; Shi, Junhua ; Xu, Ke ; Wang, Pei ; Qin, Yuan ; Li, Yiming ; Gan, Liangying ; Liu, Panna ; Xiong, Fei ; Peng, Qingfeng ; Jiang, Hongli ; Yu, Weimin ; Wang, Jianing ; Yu, Yean ; Feng, Xiaoran ; Wang, Yi ; Wang, Baoxing ; Long, Gang ; Zhang, Pengfei ; Jiang, Xinxin ; Zheng, Huixiao ; Gao, Xinlu ; Li, Yiwen ; Li, Rongshan ; Xu, Hui ; Wen, Rui ; Liu, Cangsang ; Xiong, Xinrong ; Cao, Ning ; Yang, Chun ; Chen, Wenli ; Yi, Xiangming ; Yao, Jingchun ; Xu, Jinsheng
Recombinant human erythropoietin (rhEPO) fused with human immunoglobulin G (IgG) Fc fragment (rhEPO-Fc) is a novel erythropoiesis-stimulating agent designed to extend plasma half-life and enhance biological activity. However, data on the efficacy and safety of rhEPO-Fc in hemodialysis patients with chronic kidney disease (CKD)-related anemia remain limited. This phase 3 trial enrolled patients from 45 Chinese hospitals. Participants were randomized (2:1) to receive either rhEPO-Fc or rhEPO (Chinese hamster ovary cell-derived) for 28 weeks. The rhEPO-Fc responders were eligible for a 24-week extension period. The primary endpoint was the least square mean (LSM) change in hemoglobin (Hb) levels from baseline between weeks 21 and 28. Among 356 rhEPO-Fc and 178 rhEPO recipients, patients receiving rhEPO-Fc demonstrated non-inferiority Hb maintenance compared with rhEPO. The inter-group LSM differences in the full analysis set and per-protocol set were 3.96 g/L (95% CI: 3.02-4.89; p < 0.001) and 2.27 g/L (95% CI: 0.60-3.95; p = 0.008), respectively. Adverse drug reaction rates were comparable (rhEPO-Fc: 39.2% vs. rhEPO: 40.2%). Dose adjustments due to treatment-emergent adverse events were significantly lower with rhEPO-Fc (0.0% vs. 2.2%; p < 0.05). Deaths unrelated to the study drugs occurred in two rhEPO-Fc and four rhEPO patients. These findings indicated that rhEPO-Fc effectively maintained Hb levels in patients with CKD anemia undergoing hemodialysis, showing comparable efficacy to rhEPO with reduced dosing frequency and a similar safety profile.