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ROXA-ORO is an oral generic formulation of roxadustat developed and marketed by NovaMed Pharmaceuticals for the treatment of anemia associated with chronic kidney disease (CKD). Roxadustat is a first-in-class hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitor. It works by reversibly inhibiting prolyl hydroxylase domain (PHD) enzymes (specifically EGLN1, EGLN2, and EGLN3), which prevents the degradation of hypoxia-inducible factor (HIF) alpha subunits. This stabilization of HIF-alpha mimics the physiological response to hypoxia, leading to increased endogenous production of erythropoietin (EPO), improved iron absorption and mobilization, and downregulation of hepcidin, ultimately promoting red blood cell production.
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