Assessment of the safety of Roxadustat for cardiovascular events in chronic kidney disease-related anemia using meta-analysis and bioinformatics

作者：Xiangmeng Li, Shimin Jiang, Xia Gu, Xiaojing Liu, Shunlai Shang, Jiao Zhang, Keying Pang, Wenge Li · 发表于：Frontiers in Pharmacology · 年份：2024 · DOI：10.3389/fphar.2024.1380326 · 被引用次数：8 · 研究领域：Erythropoietin and Anemia Treatment、Adipokines, Inflammation, and Metabolic Diseases、Chronic Kidney Disease and Diabetes

Objective This study compares the cardiovascular risk in anemic chronic kidney disease patients treated with Roxadustat versus erythropoietin stimulating agents (ESAs). It also explores the cardiovascular impact of Roxadustat. Methods We searched PubMed, EMBASE, Cochrane, Scopus, and Web of Science databases up to 13 August 2023, using terms such as “ESA,” “Roxadustat,” “MACE,” “stroke,” “death,” “myocardial infarction,” and “heart failure.” Two researchers independently selected and extracted data based on predefined criteria. We assessed the risk of bias with the Cochrane tool and analyzed statistical heterogeneity using the Q and I2 tests. We conducted subgroup analyses by geographical region and performed data analysis with Stata 14.0 and RevMan 5.4 software. Data were sourced from the NCBI database by filtering for “Roxadustat” and “human,” and differentially expressed genes were identified using R software, setting the significance at p < 0.01 and a 2-fold logFC, followed by GO enrichment analysis, KEGG pathway analysis, and protein interaction network analysis. Results A total of 15 articles encompassing 1,43,065 patients were analyzed, including 1,38,739 patients treated with ESA and 4,326 patients treated with Roxadustat. In the overall population meta-analysis, the incidences of Major Adverse Cardiovascular Events (MACE), death, and heart failure (HF) were 13%, 8%, and 4% in the Roxadustat group, compared to 17%, 12%, and 6% in the ESA group, respectively, wi...