Evaluating the safety and efficacy of daprodustat for anemia of chronic kidney disease: a meta-analysis of randomized clinical trials.
Purpose: Anemia of chronic kidney disease (CKD) has traditionally been treated with recombinant human erythropoietin (rhEPO). Recently, daprodustat, a hypoxia-inducible factor prolyl-hydroxylase inhibitor, has also been shown to increase hematocrit. It remains unclear whether daprodustat or rhEPO sh...
| Publicado en: | European Journal of Clinical Pharmacology Vol. 78; no. 12; pp. 1867 - 1876 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=160141325&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 160141325 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: Dec2022 vid: 78 iid: 12 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 160141325 159472250 160141325 160141325 10.1007/s00228-022-03395-y 160141325 ppf: 1867 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Evaluating the safety and efficacy of daprodustat for anemia of chronic kidney disease: a meta-analysis of randomized clinical trials. aug: au: Fatima, Kaneez Ahmed, Warda Fatimi, Asad Saulat Mahmud, Omar Mahar, Muhammad Umar Ali, Ayesha Aamir, Syed Roohan Nasim, Muhammad Taha Islam, Muhammad Bilal Maniya, Muhammad Talha Azim, Dua Marsia, Shayan Almas, Talal affil: Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan sug: subj: Anemia Drug Therapy Renal Insufficiency, Chronic Drug Therapy Erythropoietin Therapeutic Use Enzyme Inhibitors Therapeutic Use Patient Safety Drug Efficacy Treatment Outcomes Human Randomized Controlled Trials Meta Analysis Comparative Studies Confidence Intervals Hematocrit Hemoglobins Major Adverse Cardiac Events Prevention and Control Myocardial Infarction Prevention and Control ab: Purpose: Anemia of chronic kidney disease (CKD) has traditionally been treated with recombinant human erythropoietin (rhEPO). Recently, daprodustat, a hypoxia-inducible factor prolyl-hydroxylase inhibitor, has also been shown to increase hematocrit. It remains unclear whether daprodustat or rhEPO should be the treatment of choice for anemia of CKD. We aimed to assess the efficacy and cardiovascular safety of daprodustat versus rhEPO in CKD patients. Methods: Online databases were queried in April 2022 for articles comparing the efficacy and safety of daprodustat in DD-CKD and NDD-CKD subgroups. Results from trials were pooled using a random-effects model. Results: Data on 8245 CKD patients from eight clinical trials were included. Our results show that in comparison to rhEPO, daprodustat maintained the same efficacy in increasing hemoglobin levels in both the DD-CKD (MD: 0.10; 95% CI [− 0.13,0.34]; p = 0.50) and NDD-CKD (MD: − 0.01; 95% CI [− 0.38,0.35]; p = 0.95) subgroups. Daprodustat significantly lowered hepcidin levels and significantly increased TIBC in both subgroups. Additionally, daprodustat significantly reduced the incidence of major adverse cardiovascular events (MACE) (RR: 0.89; 95% CI: 0.89–0.98; p = 0.02) and its myocardial infarction (MI) component (RR: 0.74; 95% CI: 0.59–0.92; p = 0.006) in the DD-CKD subgroup. Conclusion: Daprodustat has similar efficacy compared to rhEPO for the treatment of anemia of CKD. On treatment, the reduced experience of MACE was reported in DD-CKD patients as compared to rhEPO. Furthermore, effects on iron metabolism varied by parameter, with daprodustat being superior to rhEPO in some cases and inferior in others. pubtype: Academic Journal doctype: meta analysis research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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