Normocytic anaemia is dominated by the anaemias of chronic kidney disease and inflammation, where the notable pharmacologic development is the hypoxia-inducible factor prolyl-hydroxylase inhibitors (HIF-PHIs). These oral agents raise endogenous erythropoietin, improve iron availability, and lower hepcidin — daprodustat was FDA-approved in 2023 for anaemia of CKD in dialysis patients, and roxadustat is approved in other regions — offering an oral alternative to injectable erythropoiesis-stimulating agents. Other options include luspatercept (in the relevant myeloid and thalassaemic contexts) and dialysate-delivered iron (ferric pyrophosphate citrate) to reduce intravenous iron needs. At the rare end of the spectrum, the discovery of monogenic causes such as DOCK11 deficiency, which links systemic inflammation to abnormal erythropoiesis, illustrates how mechanistic insight is expanding even in this common morphologic category.
Further reading: anaemia in CKD pathophysiology and treatments (Portolés et al., 2021); daprodustat and HIF-PHI trials; DOCK11 deficiency (Block et al., NEJM 2023).