Comparative effectiveness and acceptability of HIF prolyl-hydroxylase inhibitors versus for anemia patients with chronic kidney disease undergoing dialysis: a systematic review and network meta-analysis

作者：Qiong Huang, M. James You, Weijuan Huang, Jian Chen, Qinming Zeng, Longfeng Jiang, Xiuben Du, Xusheng Liu, Ming Hong, Jing Wang · 发表于：Frontiers in Pharmacology · 年份：2023 · DOI：10.3389/fphar.2023.1050412 · 被引用次数：6 · 研究领域：Erythropoietin and Anemia Treatment、Chronic Kidney Disease and Diabetes、Renal cell carcinoma treatment

Background : The comparative benefits and acceptability of HIF-PHIs for treating anemia have not been well researched to date. We sought to compare the effectiveness of 6 HIF-PHIs and 3 ESAs for the treatment of renal anemia patients undergoing dialysis. Data sources: Cochrane Central Register of Controlled Trials, PubMed, Embase, Cochrane Library, MEDLINE, Web of Science, and clinicaltrials.gov databases. Results: Twenty-five RCTs (involving 17,204 participants) were included, all of which were designed to achieve target Hb levels by adjusting thee dose of HIF-PHIs. Regarding the efficacy in achieving target Hb levels, no significant differences were found between HIF-PHIs and ESAs in Hb response at the dose-adjusted designed RCTs selected for comparison. Intervention with roxadustat showed a significantly lower risk of RBC transfusion than rhEPO, with an OR and 95% CI of 0.76 (0.56–0.93). Roxadustat and vadadustat had higher risks of increasing the discontinuation rate than ESAs; the former had ORs and 95% CIs of 1.58 (95% CI: 1.21–2.06) for rhEPO, 1.66 (1.16–2.38) for DPO (darbepoetin alfa), and 1.76 (1.70–4.49) for MPG-EPO, and the latter had ORs and 95% CIs of 1.71 (1.09–2.67) for rhEPO, 1.79 (1.29–2.49) for DPO, and 2.97 (1.62–5.46) for MPG-EPO. No differences were observed in the AEs and SAEs among patients who received the studied drugs. Results of a meta-analysis of gastrointestinal disorders among AEs revealed that vadadustat was less effect on causing diarrea than ...