Chen N, et al. - Researchers sought to provide additional data concerning the efficacy and safety of roxadustat vs standard therapy (epoetin alfa) for the treatment of anemia in patients undergoing dialysis. They conducted a trial in China including patients who had been undergoing dialysis and erythropoiesis-stimulating agent therapy with epoetin alfa for at least 6 weeks. They randomized 305 patients (in a 2:1 ratio) to receive roxadustat or epoetin alfa three times per week for 26 weeks. Outcomes suggest noninferiority of oral roxadustat to parenteral epoetin alfa as therapy for anemia in Chinese patients undergoing dialysis. Roxadustat vs epoetin alfa led to an increase in the transferrin level, maintenance of serum iron level, and fewer decreases in the transferrin saturation. At week 27, total cholesterol level as well low-density lipoprotein cholesterol decreased more with roxadustat vs epoetin alfa. Roxadustat and epoetin alfa group showed a mean reduction in hepcidin of 30.2 ng per milliliter and 2.3 ng per milliliter, respectively. The roxadustat group experienced hyperkalemia and upper respiratory infection at a higher frequency, and the epoetin alfa group experienced hypertension at a higher frequency.