EGLN2 egl-9 family hypoxia inducible factor 2
ENSG00000269858 · protein coding · Open Targets profile
Prolyl hydroxylase that mediates hydroxylation of proline residues in target proteins, such as ATF4, IKBKB, CEP192 and HIF1A (PubMed:11595184, PubMed:12039559, PubMed:15925519, PubMed:16509823, PubMed:17114296, PubMed:23932902). Target proteins are preferentially recognized via a LXXLAP motif (PubMed:11595184, PubMed:12039559, PubMed:15925519). Cellular oxygen sensor that catalyzes, under normoxic conditions, the post-translational formation of 4-hydroxyproline in hypoxia-inducible factor (HIF) alpha proteins (PubMed:11595184, PubMed:12039559, PubMed:12181324, PubMed:15925519, PubMed:19339211). Hydroxylates a specific proline found in each of the oxygen-dependent degradation (ODD) domains (N-terminal, NODD, and C-terminal, CODD) of HIF1A (PubMed:11595184, PubMed:12039559, PubMed:12181324, PubMed:15925519). Also hydroxylates HIF2A (PubMed:11595184, PubMed:12039559, PubMed:15925519). Has a preference for the CODD site for both HIF1A and HIF2A (PubMed:11595184, PubMed:12039559, PubMed:15925519). Hydroxylated HIFs are then targeted for proteasomal degradation via the von Hippel-Lindau ubiquitination complex (PubMed:11595184, PubMed:12039559, PubMed:15925519). Under hypoxic conditions, the hydroxylation reaction is attenuated allowing HIFs to escape degradation resulting in their translocation to the nucleus, heterodimerization with HIF1B, and increased expression of hypoxy- inducible genes (PubMed:11595184, PubMed:12039559, PubMed:15925519). EGLN2 is involved in regulating hypoxia tolerance and apoptosis in cardiac and skeletal muscle (PubMed:11595184, PubMed:12039559, PubMed:15925519). Also regulates susceptibility to normoxic oxidative neuronal death (PubMed:11595184, PubMed:12039559, PubMed:15925519). Links oxygen sensing to cell cycle and primary cilia formation by hydroxylating the critical centrosome component CEP192 which promotes its ubiquitination and subsequent proteasomal degradation (PubMed:23932902). Hydroxylates IKBKB, mediating NF-kappa-B activation in hypoxic conditions (PubMed:17114296). Also mediates hydroxylation of ATF4, leading to decreased protein stability of ATF4 (By similarity). {ECO:0000250|UniProtKB:Q91YE2, ECO:0000269|PubMed:11595184, ECO:0000269|PubMed:12039559, ECO:0000269|PubMed:12181324, ECO:0000269|PubMed:15925519, ECO:0000269|PubMed:16509823, ECO:0000269|PubMed:17114296, ECO:0000269|PubMed:19339211, ECO:0000269|PubMed:23932902}.
Each band is a group of drugs. It runs from the kind of drug on the left to the furthest stage that drug has reached in any disease on the right. Thicker bands mean more drugs.
Approved bands are highlighted. Withdrawn means the drug was pulled from the market or from development. A combined phase counts as the later one (Phase 1/2 is shown as Phase 2). Hover a band for the drug names. Source: Open Targets Platform, fetched live.
Each row is a cancer, strongest overall evidence first. The two dots show how strong the inherited (germline) and tumour-mutation (somatic) evidence is; the line between them is the gap.
Scores run from 0 (no evidence) to 1 (strongest). A missing dot at 0 means Open Targets holds no evidence of that kind. Source: Open Targets Platform, fetched live.
Tractability
- Small molecule
- Approved Drug, Structure with Ligand, High-Quality Ligand, Druggable Family
- PROTAC
- UniProt Ubiquitination, Database Ubiquitination, Small Molecule Binder
gnomAD loss of function constraint: o/e 0.39252999424934387 (upper bound 0.6044300198554993). Low values mean loss of function is poorly tolerated, a safety flag for inhibition.
Who runs trials of these drugs
Principal investigators and study chairs on 56 registry trials, updated in the last three years, of the most advanced drugs against EGLN2 (molidustat, roxadustat, vadadustat, daprodustat), ranked by Phase 2+ trials. Live from ClinicalTrials.gov.
- General ManagerTanabe Pharma Corporation · 5 of 5 trials Phase 2+
- Bentley J. BobrowThe University of Texas Health Science Center, Houston · 1 of 1 trials Phase 2+
- Dong-Xin WangPeking University First Hospital, Beijing, Beijing 100034 · 1 of 1 trials Phase 2+
- Geoffrey BlockUS Renal Care · 1 of 1 trials Phase 2+
- Li XuemeiPeking Union Medical College Hospital (Dongdan campus) No.1 Shuaifuyuan Wangfujing Dongcheng District Beijing, China 100730 · 1 of 1 trials Phase 2+
- Lin SunDepartment of Nephrology, Second Xiangya hospital of central south university, Changsha, China. · 1 of 1 trials Phase 2+
- Min YanSecond Affiliated Hospital, Zhejiang University, School of Medicine · 1 of 1 trials Phase 2+
- Qi MiaoPeking Union Medical College Hospital · 1 of 1 trials Phase 2+
- Sergiu CatrinaKarolinska institute, Centre for diabetes · 1 of 1 trials Phase 2+
- Xiangmei ChenChinese PLA General Hospital · 1 of 1 trials Phase 2+
- Yan QinPeking Union Medical College Hospital · 1 of 1 trials Phase 2+
- Xueqing YuGuangdong Provincial People's Hospital · 0 of 1 trials Phase 2+
- Zhiming YeGuangdong Provincial People's Hospital · 0 of 1 trials Phase 2+
Registry trials of molidustat, roxadustat, vadadustat, daprodustat updated in the last three years, counted by the country group of their listed sites. A trial with sites in several groups counts in each; 41 of 50 have all sites in one country.
Site counts are not patients per country, and trials registered only outside ClinicalTrials.gov are not covered. Where sites are is a fact about the record, not a judgement of its quality. Europe is the EU and EEA, the UK and Switzerland. 6 trials list no sites and are left out. Source: ClinicalTrials.gov, fetched live.
11 trials of drugs against EGLN2 were stopped early; 1 give no reason
Terminated, withdrawn and suspended interventional trials of molidustat, roxadustat, vadadustat, daprodustat, newest update first, live from ClinicalTrials.gov. Each reason is quoted exactly as the registry gives it; we do not sort reasons into safety, efficacy or business. Dates are the last registry update. Showing the 11 most recent of 11.
- terminated · 2026-08-04 · GlaxoSmithKline · matched by the registry's drug synonymsNo reason given
- withdrawn · 2026-07-07 · Peking Union Medical College Hospital · Roxadustat in combination with retinoic acid“The study has not actually been conducted.”
- terminated · 2025-12-09 · Peking Union Medical College Hospital · Roxadustat“slow enrollment and inability to reach the planned sample size within the expected timeframe”
- withdrawn · 2025-10-01 · Akebia Therapeutics · Vadadustat“Sponsor decision”
- withdrawn · 2025-10-01 · Akebia Therapeutics · vadadustat“Sponsor decision”
- terminated · 2024-08-01 · Kyntra Bio · Roxadustat“Study did not meet its primary efficacy endpoint.”
- terminated · 2024-03-27 · GlaxoSmithKline · Daprodustat“The study is terminated due to feasibility in recruitment.”
- withdrawn · 2022-07-05 · Kyntra Bio · Roxadustat“Sponsor's decision”
- terminated · 2021-02-21 · Akebia Therapeutics · vadadustat“Revised study design.”
- terminated · 2019-06-28 · GlaxoSmithKline · matched by the registry's drug synonyms“Difficulty enrolling last cohort of subjects”
- withdrawn · 2018-11-05 · Akebia Therapeutics · Vadadustat“Revised study design.”
Paediatric incentives and obligations for EGLN2's drugs
For molidustat, roxadustat, vadadustat, daprodustat: what EMA and FDA publish about paediatric plans, orphan status and pediatric approvals, and how many registered studies take children. Each line is a yes, no or not published fact from the record linked under it; none of it is a forecast.
- FDA pediatric target list: no · EGLN2 is not on the listRule: Target is on FDA's Pediatric Molecular Target List (relevant targets). Source: FDA Pediatric Molecular Target List (Listed as February 2026 on the FDA Pediatric Oncology page; the file served is 9.7.22_the_relevant_molecular_target_list.xlsx, whose Summary of Changes sheet is headed 'SEPTEMBER 2022 UPDATE' (footnote date 2022-09-01)), 2026-11-11
- EU paediatric investigation plan: yes · EMA/PE/0000245403 (vadadustat, Treatment of anaemia due to chronic disorders): PM: decision on the application for modification of an agreed PIP, 11 Jul 2025; EMEA-001452-PIP01-13-M04 (daprodustat, Treatment of anaemia due to chronic disorders): PM: decision on the application for modification of an agreed PIP, 8 Jul 2022; EMEA-001557-PIP01-13-M06 (roxadustat, Treatment of anaemia due to chronic disorders): PM: decision on the application for modification of an agreed PIP, 9 Sept 2022; EMEA-001546-PIP01-13 (molidustat (sodium), Treatment of anaemia due to chronic disorders): P: decision agreeing on a investigation plan, with or without partial waiver(s) and or deferral(s), 27 Oct 2014Rule: An EMA PIP decision (agreement, modification or waiver) lists the drug as its active substance, exact name. Source: EMA data download (dated snapshot), 2026-11-11
- EU orphan designation: no · No EU orphan designation names molidustat, roxadustat, vadadustat, daprodustatRule: An EU orphan designation lists the drug as its active substance (exact name) or belongs to a medicine that does; withdrawn and expired designations are listed with their status. Source: EMA data download (dated snapshot), 2026-11-11
- Authorised in the EU: yes · Vafseo: authorised since 24 Apr 2023; Evrenzo: authorised since 18 Aug 2021; Jesduvroq: application withdrawnRule: An EMA medicine record lists the drug as its active substance or INN, exact name; national-only authorisations are not in this file. Source: EMA data download (dated snapshot), 2026-11-11
- FDA orphan designation: not published · FDA's orphan designation database turns away automated requests, so this app does not read it; search it by hand at the linkRule: Would be: an FDA orphan designation names the drug. Source: FDA orphan designations search
- FDA pediatric oncology approval: no · FDA's table lists no pediatric approval of molidustat, roxadustat, vadadustat, daprodustatRule: FDA's Pediatric Oncology Drug Approvals table names the drug. Source: FDA Pediatric Oncology Drug Approvals (content current as of 2026-03-03), 2026-11-11
- Registered studies open to children: yes · 6 interventional studies of molidustat, roxadustat, vadadustat, daprodustat include patients under 18; 1 is recruiting, not yet recruiting or activeRule: The registry's age group includes Child (birth to 17 years), which also counts studies that set no minimum age. Source: ClinicalTrials.gov search, 2026-11-11
Rare pediatric disease voucher. FDA, content current as of 29 Apr 2026: “As of February 3, 2026, enactment of the Consolidated Appropriations Act, 2026, the rare pediatric disease PRV program will sunset after September 30, 2029. FDA may not award any PRVs under this program after September 30, 2029.” Voucher sale prices are not shown here; they appear only as company-reported news. FDA: Rare Pediatric Disease Designation and Priority Review Voucher Programs
All 4 drugs and clinical candidates as a table
Each drug, stage and indication links to its Open Targets record, where the trials and approvals behind it are listed. Salt forms (for example a mesylate) are listed as Open Targets records them, as separate entries.
| Drug | Type | Highest stage | Indications | Source records |
|---|---|---|---|---|
| MOLIDUSTAT | Small molecule | approval | anemia (phenotype), anemia, chronic kidney disease | Open Targets · ChEMBL |
| ROXADUSTAT | Small molecule | phase 4 | anemia, chronic kidney disease, anemia (phenotype), chronic renal failure syndrome, kidney disorder, stage 5 chronic kidney disease, myelodysplastic syndrome, diabetic kidney disease, +6 more | Open Targets · ChEMBL |
| VADADUSTAT | Small molecule | phase 4 | anemia, anemia (phenotype), chronic kidney disease, acute respiratory distress syndrome | Open Targets · ChEMBL |
| DAPRODUSTAT | Small molecule | phase 4 | anemia, anemia (phenotype), chronic kidney disease, autism spectrum disorder, peripheral arterial disease, diabetic foot | Open Targets · ChEMBL |