Jesduvroq vs. Aranesp: How do they compare?

Jesduvroq and Aranesp are both used to raise hemoglobin levels and to treat anemia associated with chronic kidney disease (CKD). However, they differ in their active ingredients, indications, ways of working in the body, routes, frequency of administration, side effect profiles, and warnings. Neither Jesduvroq nor Aranesp have been proven to improve quality of life, tiredness (fatigue), or well-being.

What is the difference in active ingredients between Jesduvroq and Aranesp?

Jesduvroq is the brand (trade) name for daprodustat, which belongs to the class of medicines called hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHI).

Aranesp is the brand(trade) name for darbepoetin alfa, which is a recombinant human erythropoietin (a man-made version of the naturally occurring human hormone, erythropoietin).

What are Jesduvroq and Aranesp used to treat?

Jesduvroq is approved to treat anemia due to CKD in adults who have been receiving dialysis for at least four months. It should not be used in patients who are NOT on dialysis nor as a substitute for a blood transfusion in patients requiring an immediate correction of their anemia.

Aranesp is approved to treat anemia due to CKD in patients on dialysis and patients not on dialysis.
It may also be used to treat anemia due to concomitant myelosuppressive chemotherapy, in patients with a minimum of two additional months of planned chemotherapy.

What is the mechanism of action of Jesduvroq and Aranesp?

Jesduvroq acts on an enzyme called hypoxia-inducible factor prolyl hydroxylase (HIF-PH). This stimulates the release of erythropoietin which naturally occurs when oxygen levels are low. Erythropoietin is a hormone that increases the production of red blood cells, thereby reducing the symptoms of anemia. Jesduvroq is currently the only oral HIF-PHI inhibitor approved in the United States.

Aranesp acts like our naturally occurring (endogenous) erythropoietin to stimulate erythropoiesis, which is the process of red blood cell production. Endogenous erythropoietin is secreted by the interstitial cells in our kidneys when oxygen levels are low. It protects red blood cells from destruction and at the same time, stimulates stem cells of the bone marrow to increase the production of red blood cells.

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What are the differences in the way Jesduvroq and Aranesp are administered?

Jesduvroq is a once-daily oral tablet that is taken by mouth. It can be taken with or without food, and supplements such as iron or phosphate binders can be taken at the same time.

Aranesp is an injection that can be given subcutaneously (under the skin) or by IV infusion, once every one to four weeks. A healthcare provider usually administers it initially but they can teach you how to administer subsequent injections subcutaneously yourself at home.

What are the differences in side effects between way Jesduvroq and Aranesp?

The most common side effects of Jesduvroq are high blood pressure, thrombotic vascular events (such as blood clots, myocardial infarction, and stroke), and abdominal pain. Dizziness and hypersensitivity reactions were also common. It carries a black-boxed warning for an increased risk of death, myocardial infarction, venous thromboembolism, and thrombosis of vascular access. Hemoglobin levels greater than 11 g/dL are expected to further increase this risk, but no trial has identified a hemoglobin target level, dose of Jesduvroq, or dosing strategy that does not increase these risks. The lowest dose of Jesduvroq should be used which is sufficient to reduce the need for red blood cell transfusions.

The most common side effects of Aranesp are high blood pressure, shortness of breath, edema in the legs, cough, procedural low blood pressure, angina, and rash. It also carries a black-boxed warning for an increased risk of death, myocardial infarction, venous thromboembolism, and thrombosis of vascular access. Hemoglobin levels greater than 11 g/dL are expected to further increase this risk, but no trial has identified a hemoglobin target level, dose of Aranesp, or dosing strategy that does not increase these risks. The lowest dose of Aranesp should be used which is sufficient to reduce the need for red blood cell transfusions.