Prolyl Hydroxylase Inhibitors: A Breakthrough in the Therapy of Anemia Associated with Chronic Diseases

J Med Chem. 2018 Aug 23;61(16):6964-6982. doi: 10.1021/acs.jmedchem.7b01686. Epub 2018 May 9.


Chronic kidney disease, cancer, chronic inflammatory disorders, nutritional, and genetic deficiency can cause anemia. Hypoxia causes induction of hypoxia-inducible factor (HIF), which stimulates erythropoietin (EPO) synthesis. Prolyl hydroxylase domain (PHD) enzyme inhibition can stabilize hypoxia-inducible factor (HIF). HIF stabilization also decreases hepcidin, a hormone of hepatic origin, which regulates iron homeostasis. PHD inhibitors represent a novel pharmacological treatment of anemia associated with chronic diseases. Many orally active PHD inhibitors like roxadustat, molidustat, vadadustat, and desidustat are in late phase clinical trials. This review discusses the role of PHD inhibitors in the treatment of anemia associated with chronic diseases.

Publication types

  • Review

MeSH terms

  • Anemia / drug therapy*
  • Genetic Diseases, Inborn / drug therapy*
  • Humans
  • Inflammatory Bowel Diseases / drug therapy*
  • Neoplasms / drug therapy*
  • Prolyl-Hydroxylase Inhibitors / chemistry
  • Prolyl-Hydroxylase Inhibitors / pharmacology*
  • Renal Insufficiency, Chronic / drug therapy*


  • Prolyl-Hydroxylase Inhibitors