Zhongguo quanke yixue (Feb 2023)
Effectiveness and Safety of Roxadustat for Renal Anemia in Dialysis-dependent Chronic Kidney Disease: a Meta-analysis
Abstract
Background As the most common clinical manifestation and a major complication in chronic kidney disease, anemia affects the patients' quality of life, increases the risk of renal disease progression and death. Hence, it is important to improve anemia, and monitor and evaluate drug efficacy and safety in the treatment of renal anemia. Objective To compare the efficacy and safety between roxadustat and erythropoiesis stimulating agents (ESAs) in treating renal anemia in patients with dialysis-dependent chronic kidney disease. Methods We searched PubMed, FMRS, Wanfang Data and ClinicalTrials.gov from inception to January 19, 2022 for randomized controlled trials (RCTs) about maintenance hemodialysis patients with dialysis duraion≥3 months treated with oral roxadustat (experimental group), versus injection of ESAs (control group). Two researchers independently conducted literature screening, data extraction and quality evaluation. Meta-analysis was performed using Review Manager 5.3. Results A total of 5 studies with 6 RCTs were included, involving 901 patients (549 in the experimental group and 352 in the control group). Meta-analysis showed that roxadustat was superior to ESAs in improving the levels of serum iron〔MD=2.49, 95%CI (0.82, 4.16), P=0.004〕, transferrin〔MD=0.31, 95%CI (0.17, 0.44), P<0.000 01〕, total iron-binding capacity〔MD=7.51, 95%CI (5.01, 10.01), P<0.000 01〕. The incidence of adverse events did not differ significantly between the two groups〔RR=1.10, 95%CI (0.99, 1.22), P=0.07〕. Conclusion Roxadustat demonstrates better effects than ESAs in increasing the levels of serum iron, transferrin and total iron-binding capacity, without increasing the risk of adverse events during a short-term duration of use.
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