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Enalodustat is an orally active small molecule inhibitor of hypoxia-inducible factor prolyl hydroxylase (HIF-PH). By inhibiting the HIF-PH enzyme, enalodustat stabilizes HIF-α subunits, which then dimerize with HIF-β to form a transcription factor complex. This complex induces the expression of erythropoietin (EPO) and other genes involved in iron transport and erythropoiesis, effectively stimulating red blood cell production. Developed by Japan Tobacco and marketed by Torii Pharmaceutical, enalodustat (brand name Enaroy) was approved in Japan in 2020 for the treatment of anemia associated with chronic kidney disease (CKD) in both dialysis-dependent and non-dialysis-dependent patients. It is also being investigated for its potential benefits in heart failure patients with concomitant renal anemia.
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