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罗沙司他治疗血液透析患者肾性贫血的有效性和安全性系统评价和Meta分析

摘要:背景 贫血是慢性肾病患者最常见的临床表现,也是肾脏疾病的主要并发症,影响患者的生命质量、加速疾病进展和死亡的风险,纠正贫血和监测改善肾性贫血药物的疗效及安全性意义重大。目的 比较罗沙司他和红细胞生成刺激剂在治疗维持性血液透析患者肾性贫血中的疗效和安全性。方法 在PubMed、FMRS、万方数据库中共计检索出535篇相关文章,据纳入和排除标准筛选文献,然后用CONSORT 2010表格评估,采用Review Manager 5.3软件进行统计分析。结果 最终共纳入5篇文献,包括6项随机对照研究、901例患者。其中罗沙司他组549例,红细胞生成刺激剂组352例。Meta分析显示,相较红细胞生成素刺激素组,罗沙司他组在提高血透患者的血清铁、转铁蛋白、总铁结合力方面均优于促红细胞生成素组。两组不良事件发生率无统计学差异。结论 罗沙司他可以有效纠正维持性血液透析患者的肾性贫血,在升高血清铁、转铁蛋白、总铁结合力方面较红细胞刺激剂效果更好。短期内使用罗沙司他未增加不良事件风险。

英文摘要:Background Anemia is a common clinical manifestation in chronic kidney disease patients, and is also a major complication of kidney disease. Anemia affects the patients’ quality of life, increases the risk of renal disease progression and death. It is important to correct anemia, monitor and evaluate the efficacy and safety of drugs in the treatment of renal anemia. Objective To compare the efficacy and safety between roxadustat and Erythropoiesis-stimulating agents (ESAs) in the renal anemia patients with dialysis-dependent chronic kidney disease. Methods We searched PubMed, FMRS and WanFang. Initially, 535 articles were retrieved from major databases. Then we extracted the data after reviewing the literature based on inclusion and exclusion criteria. The full-text and supplementary materials from the original trial reports were assessed using a standardized form (CONSORT 2010 checklist of information).The statistical analysis was conducted by Review Manager 5.3 software. Results A total of 5 articles that 6 randomized controlled trials (RCTs) were included. These comprised 901 patients: 549 in the roxadustat group and 352 in the ESAs group. Meta-analysis showed that roxadustat group had a better effect on the increased serum iron, transferrin, total iron binding capacity than the ESAs group. The incidence of adverse events (AEs) did not differ significantly between the two groups.Conclusion: Roxadustat improved renal anemia by improving the level of serum iron, transferrin, and TIBC. The risk of AEs was not increased with the short-term use of roxadustat.

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[V1] 2022-08-12 18:31:09 chinaXiv:202208.00088V1 下载全文
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