Summary
Epoetin Alfa has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in Chronic Kidney Disease would be drug repurposing rather than first-in-human development. This does not mean it is approved for Chronic Kidney Disease. ClinicalTrials.gov lists 8 registered trials linking Epoetin Alfa to Chronic Kidney Disease: 7 have completed; 1 is terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT01191983). The largest enrolment is 1228 participants (NCT00090753). Registration activity spans 2002 to 2019. The literature layer holds 13 publications for this pair: 5 Cochrane reviews, 2 meta-analyses, 1 randomised controlled trial publication and 5 clinical trial publications. Publication years run from 2014 to 2026. Because at least one synthesis-level source exists (systematic review, meta-analysis or Cochrane review), this pair has been assessed beyond single studies, although the synthesis may concern a different indication.
The RepurpOS disease-intelligence file for Chronic Kidney Disease ranks 534 candidate therapeutics from Open Targets, ChEMBL, DGIdb and PubMed; only a minority carry direct clinical evidence, and this page covers one of those. Spontaneous remission context recorded for the condition: GFR decline averages 2-5 mL/min/year on standard care (ACE/ARB + blood pressure control); progression to end-stage renal disease (ESRD) in ~20-30% at 10 years for moderate CKD; reversal essentially impossible once structural fibrosis established.
Evidence table
| Evidence tier | A · Strong |
|---|---|
| Evidence score | 79.0 (trials 29.0, literature 30.0, tier 15, approved bonus 5.0) |
| Registered trials | 8 total: 0 recruiting, 0 active / not yet recruiting, 7 completed, 1 other |
| Linked publications | 13 (5 Cochrane reviews, 5 clinical trial publications, 2 meta-analyses, 1 randomised controlled trial publication) |
| Agent type | Biologic |
| Development stage (any indication) | Approved |
| Mechanism / class | Not recorded |
| Data sources | Open Targets, ChEMBL |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT01191983 | A Study of Methoxy Polyethylene Glycol-Epoetin Beta (Mircera) for the Treatment of Chronic Renal Anemia in Participants With Diabetic Nephropathy 2010 | completed | Phase 4 | 102 |
| NCT00090753 | A Study of Intravenous or Subcutaneous Methoxy Polyethylene Glycol-Epoetin Beta (RO0503821, Mircera) in Chronic Kidney Disease Patients With Renal Anemia 2004 | completed | Phase 3 | 1,228 |
| NCT00121602 | Efficacy Study: Darbepoetin Alfa for the Treatment of Anemia in Patients With Chronic Kidney Disease 2005 | completed | Phase 3 | 446 |
| NCT00598273 | Safety & Efficacy of Peginesatide for the Treatment of Anemia in Participants With Chronic Renal Failure Not on Dialysis 2007 | completed | Phase 3 | 490 |
| NCT00156962 | Epoetin Alfa (EPO) in Subjects With Chronic Kidney Disease (CKD) 2005 | terminated | Phase 3 | 850 |
| NCT00307814 | A Study to Evaluate PROCRIT (Epoetin Alfa) for Maintenance Phase Treatment of Patients With Anemia Due to Chronic Kidney Disease (PROMPT) 2002 | completed | Phase 2 | 519 |
| NCT05373303 | The Clinical Study for Evaluating The Safety And Efficacy Of Epodion® 2019 | completed | Not applicable | 82 |
| NCT01422824 | An Observational Study of Mircera (Methoxy Polyethylene Glycol-Epoetin Beta) as Maintenance Treatment in Patients With Chronic Renal Anemia on Haemodialysis 2010 | completed | Not applicable | 185 |
Published literature
- Clinical trial publication Efficacy, safety, and immunogenicity of UB-851 versus ® in patients with renal anemia receiving hemodialysis: A randomized, double-masked, phase III trialWu CH, Shiao CC, Wang HY et al. · Journal of the Chinese Medical Association : JCMA · 2026 · PMID 41396155
- Clinical trial publication Efficacy and safety of daprodustat in patients on peritoneal dialysis in the ASCEND-D trialDasgupta I, Meadowcroft AM, Bhatt PR et al. · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025 · PMID 39817409
- Cochrane review Comparative efficacy of epoetin alfa vs. darbepoetin in children with chronic kidney disease: a systematic review, meta-analysis and cost-effectiveness analysisBertazza Partigiani N, D'Uva A, Vigezzi S et al. · Journal of nephrology · 2025 · PMID 40349276
- Clinical trial publication Subcutaneous C.E.R.A. for the Maintenance Treatment of Anemia in Pediatric Patients With CKD: A Phase 2, Open-Label, Single-Arm, Multicenter StudyWarady BA, Meyer Reigner S, Tirodkar C et al. · American journal of kidney diseases : the official journal of the National Kidney Foundation · 2023 · PMID 36587890
- Cochrane review Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysisChung EY, Palmer SC, Saglimbene VM et al. · The Cochrane database of systematic reviews · 2023 · PMID 36791280
- Clinical trial publication Biosimilar erythropoietin in anemia treatment (BEAT)-Efficacy and safety of a 1:1 dose conversion from EPREX® to EPIAO® in patients with end-stage renal disease on hemodialysis: A prospective, randomized, double blind, parallel group studyMiao B, Isachkina AN, Shutov EV et al. · Medicine · 2022 · PMID 36451454
- Clinical trial publication Three Times Weekly Dosing of Daprodustat versus Conventional Epoetin for Treatment of Anemia in Hemodialysis Patients: ASCEND-TD: A Phase 3 Randomized, Double-Blind, Noninferiority TrialCoyne DW, Singh AK, Lopes RD et al. · Clinical journal of the American Society of Nephrology : CJASN · 2022 · PMID 35918106
- Randomized controlled trial Desidustat in Anemia due to Dialysis-Dependent Chronic Kidney Disease: A Phase 3 Study (DREAM-D)Gang S, Khetan P, Varade D et al. · American journal of nephrology · 2022 · PMID 35462369
- Meta-analysis The efficacy and safety of roxadustat for anemia in patients with chronic kidney disease: a meta-analysisZheng Q, Yang H, Fu X et al. · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021 · PMID 33051677
- Meta-analysis Roxadustat (FG-4592) treatment for anemia in dialysis-dependent (DD) and not dialysis-dependent (NDD) chronic kidney disease patients: A systematic review and meta-analysisLiu J, Zhang A, Hayden JC et al. · Pharmacological research · 2020 · PMID 32171893
- Cochrane review Economic and quality of life burden of anemia on patients with CKD on dialysis: a systematic reviewSpinowitz B, Pecoits-Filho R, Winkelmayer WC et al. · Journal of medical economics · 2019 · PMID 30813807
- Cochrane review Continuous erythropoiesis receptor activator (CERA) for the anaemia of chronic kidney diseaseSaglimbene VM, Palmer SC, Ruospo M et al. · The Cochrane database of systematic reviews · 2017 · PMID 28782299
- Cochrane review Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysisPalmer SC, Saglimbene V, Mavridis D et al. · The Cochrane database of systematic reviews · 2014 · PMID 25486075
Mechanism and notes
No mechanism of action is recorded for this pair in the source databases.
OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL. The tier describes how well the drug-disease link is documented, not how well the drug works.
Frequently asked questions
Is Epoetin Alfa approved for Chronic Kidney Disease?
Epoetin Alfa has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in Chronic Kidney Disease would be drug repurposing rather than first-in-human development. This does not mean it is approved for Chronic Kidney Disease. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Epoetin Alfa in clinical trials for Chronic Kidney Disease?
ClinicalTrials.gov lists 8 registered trials linking Epoetin Alfa to Chronic Kidney Disease: 7 have completed; 1 is terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT01191983). The largest enrolment is 1228 participants (NCT00090753). Registration activity spans 2002 to 2019.
What does the evidence show for Epoetin Alfa in Chronic Kidney Disease?
Epoetin Alfa has both completed registered trials and synthesis-level publications linked to Chronic Kidney Disease. That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit. OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL. The tier describes how well the drug-disease link is documented, not how well the drug works.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.