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Long-Acting ESAs for Renal Anemia in China: CERA Tops AssessmentNew Assessment Scores Help Choose Treatments for Renal Anemia

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Key Takeaway
CERA, pegmolesatide, and darbepoetin alfa all exceeded the 70-point threshold for strong recommendation in renal anemia.

A health technology assessment evaluated three long-acting erythropoiesis-stimulating agents (ESAs) for treating renal anemia in China. The assessment used a multidimensional scoring system covering efficacy, safety, pharmaceutical properties, economy, and other attributes. All three drugs exceeded the 70-point threshold required for inclusion in the list of strongly recommended drugs.

CERA received the highest overall score of 80.39 points, driven by top performance in safety and other attributes. Pegmolesatide scored 73.04 points and ranked best in pharmaceutical properties. Darbepoetin alfa scored 71.70 points and ranked first in economy.

The findings provide a basis for medical institutions to select long-acting ESAs for renal anemia. However, this is a health technology assessment based on a scoring system, not a clinical trial. No adverse events, serious adverse events, discontinuations, or tolerability data were reported. Limitations, funding sources, and conflicts of interest were not reported. The results should not be overinterpreted as direct evidence of comparative clinical effectiveness or safety.

How this fits prior evidence

This assessment addresses a gap in the selection of long-acting ESAs for renal anemia. While prior evidence noted that roxadustat-based regimens show higher mean hemoglobin levels than ESA-based regimens in peritoneal dialysis, this assessment provides a specific scoring framework for choosing between different ESAs, including CERA, pegmolesatide, and darbepoetin alfa.

A health technology assessment evaluated three long-acting erythropoiesis-stimulating agents (ESAs) to help doctors choose the best treatment for patients with renal anemia. The three drugs studied were CERA, pegmolesatide, and darbepoetin alfa. These medications are used to manage anemia caused by kidney issues.

Each drug was scored based on its effectiveness, safety, pharmaceutical properties, and cost. All three medications scored above 70 points, which is the threshold for a strong recommendation. CERA received the highest score for safety and other attributes. Pegmolesatide performed best in terms of pharmaceutical properties, while darbepoetin alfa was ranked first for its economic value.

Because this was a health technology assessment rather than a clinical trial, the results are based on a scoring system rather than direct patient observation. These findings provide a framework for medical institutions to choose the most suitable treatment based on specific needs like safety or cost. Patients should talk to their doctors to determine which option is best for their specific condition.

What this means for you:
Three long-acting drugs for renal anemia met high standards for safety, quality, and cost in a new assessment.

Common questions

What are the different drugs used for renal anemia in this study?

The assessment looked at three specific long-acting erythropoiesis-stimulating agents (ESAs). These are CERA, pegmolesatide, and darbepoetin alfa. All three medications scored above the 70-point threshold required for a strong recommendation in the study's evaluation system.

How do these medications compare in safety and cost?

The drugs were scored on different strengths. CERA received the highest score for safety and other attributes. Darbepoetin alfa was ranked first for economy, while pegmolesatide performed best in pharmaceutical properties. All three are considered strong options for treating renal anemia.

Is this study a clinical trial for these medications?

No, this was a health technology assessment rather than a clinical trial. It used a scoring system to evaluate the drugs' properties and safety. Because it is a scoring assessment, patients should consult their doctors to decide which treatment is right for them.

Study Details

Study typeGuideline
EvidenceLevel 5
PublishedOct 2026
View Original Abstract ↓
IntroductionRenal anemia is a common complication of chronic kidney disease (CKD) and is associated with increased cardiovascular morbidity and mortality and reduced quality of life. Long-acting erythropoiesis-stimulating agents (ESAs) offer advantages in dosing convenience and adherence, but a comprehensive multidimensional evaluation comparing these agents within the Chinese healthcare context is lacking.ObjectiveThe aim of this study was to conduct a multidimensional quantitative evaluation of long-acting ESAs and provide a reference for drug selection and rational clinical use in medical institutions.MethodsBased on the method recommended in the Rapid Guideline for Drug Evaluation and Selection in Chinese Medical Institutions (Third Edition), three long-acting ESAs were evaluated in five dimensions, namely, efficacy (28 points), safety (27 points), pharmaceutical properties (27 points), economy (10 points), and other attributes (8 points).ResultsThe final assessment scores were 80.39 points for the continuous erythropoietin receptor activator (CERA), 73.04 points for pegmolesatide, and 71.70 points for darbepoetin alfa, in descending order. CERA achieved the highest scores in safety and other attributes, darbepoetin alfa ranked first in economy, and pegmolesatide performed best in pharmaceutical properties.ConclusionAccording to the scoring results, CERA, pegmolesatide, and darbepoetin alfa all exceeded the guideline-defined threshold for strong recommendation (>70 points) and can be included in the list of strongly recommended drugs for medical institutions. This study provides a scientific, reasonable, and safe basis for medical institutions to select long-acting ESAs.
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