{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:02:54Z","timestamp":1789948974427,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP25K18676"],"award-info":[{"award-number":["JP25K18676"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Hypoxia\u2010inducible factor prolyl hydroxylase inhibitors (HIF\u2010PHIs) are increasingly used to treat renal anemia in patients with chronic kidney disease (CKD). We evaluated the risk of heart failure associated with HIF\u2010PHIs compared with erythropoiesis\u2010stimulating agents (ESAs) in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide, retrospective, active\u2010comparator cohort study using a Japanese claims database. We included adults with non\u2010dialysis CKD and heart failure initiating HIF\u2010PHIs or ESAs alongside diuretic therapy between August 2020 and March 2025. The primary outcome was heart failure hospitalization. Secondary outcomes included emergency heart failure hospitalization and hospitalization requiring intravenous diuretics. Baseline characteristics were balanced using inverse probability of treatment weighting (IPTW) based on propensity scores. Hazard ratios (HRs), 95% confidence intervals (CIs), and sensitivity analyses were evaluated in predefined subgroups using Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohorts comprised 14\u2009995 HIF\u2010PHI and 22\u2009889 ESA users with baseline characteristics well balanced after IPTW adjustment. Heart failure hospitalization incidence rates per 1000 person\u2010years (PY) were 157.8 for HIF\u2010PHIs and 177.0 for ESAs. HRs were 0.93 [95% CI 0.87\u20131.01] for heart failure hospitalization, 0.94 [95% CI 0.84\u20131.03] for emergency heart failure, and 0.87 [95% CI 0.81\u20130.94] for intravenous diuretic administration. Results were generally consistent across subgroup and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although residual confounding cannot be excluded because of the observational study design, HIF\u2010PHIs were not associated with evidence of an increased risk of heart failure hospitalization in patients with heart failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70453","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T08:08:18Z","timestamp":1787990898000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of Heart Failure Hospitalization Associated With Hypoxia\u2010Inducible Factor Prolyl Hydroxylase Inhibitors Versus Erythropoiesis\u2010Stimulating Agents: A Nationwide Claims\u2010Based Cohort Study"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0331-6417","authenticated-orcid":false,"given":"Yuki","family":"Kunitsu","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics Kyoto University Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7640-8318","authenticated-orcid":false,"given":"Keiko","family":"Ikuta","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics Kyoto University Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8344-2469","authenticated-orcid":false,"given":"Daiki","family":"Hira","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics Kyoto University Hospital  Kyoto Japan"},{"name":"Graduate School of Pharmaceutical Sciences Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1285-122X","authenticated-orcid":false,"given":"Shunsaku","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics Kyoto University Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4559-9753","authenticated-orcid":false,"given":"Tomohiro","family":"Terada","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics Kyoto University Hospital  Kyoto 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