Effect of Roxadustat on Lipid Profile in Cirrhosis of Liver Patients

Abstract

Background: Cirrhosis-induced dyslipidemia significantly exacerbates hepatic decline and cardiovascular risk. Emerging evidence suggests that roxadustat, a hypoxia-inducible factor stabilizer, may beneficially modulate lipid metabolism in cirrhotic patients. Objective: This study evaluated the effect of roxadustat on serum lipid profiles and hemoglobin levels in patients with liver cirrhosis at BSMMU, Dhaka, aiming to provide a novel therapeutic strategy for dyslipidemia management. Methods: A prospective controlled trial was conducted at the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from December 2022 to February 2024. Group A comprised 75 patients (50 in the roxadustat group and 25 in the control group) at baseline. Group B included follow-up data from 45 roxadustat and 22 control patients. Standard biochemical assays and advanced lipidomic profiling were employed to measure total cholesterol, LDL-C, HDL-C, triglycerides, and hemoglobin levels. Results: In Group A, the roxadustat group exhibited an 18% reduction in total cholesterol, a 22% decrease in LDL-C, and a 20% reduction in triglycerides, along with a 15% increase in HDL-C compared to baseline values. Notably, hemoglobin levels increased significantly from 9.78 ± 1.43 g/dL to 11.04 ± 1.39 g/dL (12.9% improvement). In Group B, 70% of patients receiving roxadustat demonstrated marked lipid profile improvements with a calculated Cohen’s d of 0.85, whereas the control group showed minimal changes (<5%), with differences reaching statistical significance (p < 0.05). Conclusion: Roxadustat markedly improves dyslipidemia and hemoglobin levels in cirrhotic patients. These dual benefits position it as a promising therapeutic option, warranting further clinical validation.