Small molecule discovery and development company Akebia Therapeutics Inc. has started a second Phase 1 clinical trial of its anemia drug–another baton hand-off in a race with big drug companies to get to market first with a safer, more effective, less expensive oral treatment.

Midwest health care start-ups attracted $780 million in investments in 2009, according to the BioEnterprise Midwest Health Care Venture Investment Report. While the number of companies winning investments last year — 156 — was about the same as in 2008, the dollar volume of the investments dropped 26 percent.

The successful completion of the trial in healthy human volunteers is a major milestone and kicks off what’s shaping up to be a big year for the fledgling Cincinnati company.

Akebia Therapeutics is furthest along on an anemia pill that the company hopes will take the place of hormone injections. But there seems to be event more excitement in the business about a second treatment, meant to treat vascular leak. “These are multi-billion dollar markets,” Chief Financial Officer Ian Howes stated.

Akebia’s anemia drug, known only as AKB-6548, passed an important milestone recently when Akebia embarked on a Phase I clinical trial and the first steps toward bedside use. The pill manipulates genes to produce the erythropoietin (EPO) hormone that promotes the growth of red blood cells in bone marrow. It aspires to replace riskier injections and treat other anemia sufferers who can’t handle current treatments.

The drug, AKB-6548, is an alternative to injections of the erythropoietin (EPO) hormone that promotes the growth of red blood cells in the kidney. Akebia’s drug increases the natural production of EPO and, if successful through trials, the company thinks it can cut the costs of anemia treatments and expand the treatment to others who can’t take EPO injections for health reasons.

Akebia called Dzao a pioneer in gene therapy for vascular disease. His research on the renin-angiotensin system (RAS), which regulates blood pressure, is credited with helping understand the role of the system in cardiovascular disease and develop RAS-based drugs.

The company stated it raised additional money to ensure the development of two of its drugs. Akebia plans later this year to start Phase I clinical trials on an oral medication designed to create new red blood cells in anemia patients. In addition, it wants to establish a human clinical proof of concept for a second drug that prevents vascular leak syndrome, in which blood components leak out of veins and into other systems — a side effect of some cancer treatments.

Akebia stated it wants Ian A. W. Howes to help expand its pipeline of drugs. Along with anemia and vascular treatments, the company is also developing wound healing and cancer therapies.