دورية أكاديمية
أعرض في EDS

Safety and Efficacy of Hypoxia-Inducible Factor-Prolyl Hydroxylase Inhibitors vs. Erythropoietin-Stimulating Agents in Treating Anemia in Renal Patients (With or Without Dialysis): A Meta-Analysis and Systematic Review.

التفاصيل البيبلوغرافية
العنوان: Safety and Efficacy of Hypoxia-Inducible Factor-Prolyl Hydroxylase Inhibitors vs. Erythropoietin-Stimulating Agents in Treating Anemia in Renal Patients (With or Without Dialysis): A Meta-Analysis and Systematic Review.
المؤلفون: Damarlapally N; Health Sciences and Medicine, Houston Community College, Houston, USA., Thimmappa V; Prosthodontics, Mariner Dental Laboratory, Houston, USA., Irfan H; Internal Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, PAK., Sikandari M; Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK., Madhu K; Internal Medicine, Gujarat Medical Education and Research Society (GMERS) Medical College, Gandhinagar, Gandhinagar, IND., Desai A; Internal Medicine, Gujarat Medical Education and Research Society (GMERS) Medical College, Gandhinagar, Gandhinagar, IND., Pavani P; General Surgery, Kurnool Medical College, Andhra Pradesh, IND., Zakir S; Internal Medicine, Dow University of Health Sciences, Karachi, PAK., Gupta M; Internal Medicine, Subharti Medical College, New Delhi, IND., Khosa MM; Internal Medicine, Quetta Institute of Medical Sciences, Quetta, PAK., Kotak S; Internal Medicine, Dow University of Health Sciences, Karachi, PAK., Varrassi G; Pain Medicine, Paolo Procacci Foundation, Rome, ITA., Khatri M; Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK., Kumar S; Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK.
المصدر: Cureus [Cureus] 2023 Oct 21; Vol. 15 (10), pp. e47430. Date of Electronic Publication: 2023 Oct 21 (Print Publication: 2023).
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Palo Alto, CA : Cureus, Inc.
مستخلص: Hypoxia-inducible factor-prolyl hydroxylase domain inhibitors (HIF-PHIs) are a novel group of drugs used to treat renal anemia, but their benefits vary among different trials. Our meta-analysis aims to assess the safety and efficacy of HIF-PHI versus erythropoiesis-stimulating agents (ESA) in managing anemia among patients with chronic kidney disease (CKD), regardless of their dialysis status. PubMed, Embase, and Google Scholar were queried to discover eligible randomized controlled trials (RCTs). To quantify the specific effects of HIF-PHI, we estimated pooled mean differences (MDs) and relative risks (RR) with 95% CIs. Our meta-analysis involved 22,151 CKD patients, with 11,234 receiving HIF-PHI and 10,917 receiving ESA from 19 different RCTs. The HIF-PHI used included roxadustat, daprodustat, and vadadustat. HIF-PHI yielded a slight but significant increase in change in mean hemoglobin (Hb) levels (MD: 0.06, 95% CI (0.00, 0.11); p = 0.03), with the maximum significant increase shown in roxadustat followed by daprodustat as compared to ESA. There was a significant decrease in efficacy outcomes such as change in mean iron (MD: -1.54, 95% CI (-3.01, -0.06); p = 0.04), change in mean hepcidin (MD: -21.04, 95% CI (-28.92, -13.17); p < 0.00001), change in mean ferritin (MD: -16.45, 95% CI (-27.17,-5.73); p = 0.03) with roxadustat showing maximum efficacy followed by daprodustat. As for safety, HIF-PHI showed significantly increased incidence in safety outcomes such as diarrhea (MD: 1.3, 95% CI (1.11, 1.51); p = 0.001), adverse events leading to withdrawal (MD: 2.03, 95% CI (1.5, 2.74), p = 0.00001) among 25 various analyzed outcomes. This meta-analysis indicates that HIF-PHIs present a potentially safer and more effective alternative to ESAs, with increased Hb levels and decreased iron usage in CKD patients without significantly increasing adverse events. Therefore, in these patients, we propose HIF-PHI alongside renal anemia treatment.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2023, Damarlapally et al.)
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فهرسة مساهمة: Keywords: and efficacy; anemia; dialysis; erythropoietin stimulating agents; hypoxic inducible factors prolyl hydroxylase inhibitors; kidney; renal; safety; treatment; without dialysis
تواريخ الأحداث: Date Created: 20231129 Latest Revision: 20231201
رمز التحديث: 20231201
مُعرف محوري في PubMed: PMC10659060
DOI: 10.7759/cureus.47430
PMID: 38021836
قاعدة البيانات: MEDLINE
الوصف
تدمد:2168-8184
DOI:10.7759/cureus.47430