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The combination of **epoetin alfa** (Epogen) and **vadadustat** (Vafseo) refers to a clinical regimen evaluated in the Phase 3 VOTE trial. Epoetin alfa is a recombinant human erythropoiesis-stimulating agent (ESA) that acts as an agonist of the erythropoietin receptor to stimulate red blood cell production. Vadadustat is an oral small molecule inhibitor of hypoxia-inducible factor prolyl hydroxylase (HIF-PHD). By inhibiting HIF-PHD, vadadustat stabilizes HIF-alpha, simulating the body's natural response to hypoxia and stimulating endogenous erythropoietin production. The VOTE study specifically assessed the safety and efficacy of a phased transition from intravenous epoetin alfa to thrice-weekly oral vadadustat in adult patients with anemia secondary to chronic kidney disease (CKD) who were receiving in-center hemodialysis.
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