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一项关于铁氧体用于治疗慢性肾脏病患者贫血的疗效和安全性的系统评价和荟萃分析。

A systemic review and meta-analysis on the efficacy and safety of ferumoxytol for anemia in chronic kidney disease patients.

机构信息

Department of Nephrology, People's Hospital of Qijiang Distract, Chongqing, P.R. China.

Department of Nursing, People's Hospital of Qijiang Distract, Chongqing, P.R. China.

出版信息

Ren Fail. 2022 Dec;44(1):94-102. doi: 10.1080/0886022X.2021.2021237.

Abstract

PURPOSE

To evaluate the efficacy of ferumoxytol, relative to conventional iron supplement formulations, on hemoglobin levels, ferritin level, and adverse event incidence in chronic kidney disease patients.

METHODS

We performed a systematic search of six academic databases (EMBASE, CENTRAL, Scopus, PubMed, Web of sciences, and MEDLINE), adhering to PRISMA guidelines. We performed a meta-analysis on relevant studies to evaluate the overall influence of ferumoxytol, relative to conventional iron supplement formulations, on hemoglobin levels, ferritin level, and treatment related treatment emergent adverse events (TEAEs) incidence in chronic kidney disease patients.

RESULTS

Seven eligible studies were identified from a total of 1397 studies. These studies contained data on 3315 participants with chronic kidney disease (mean age: 59.2 ± 4.6 years). A meta-analysis revealed that ferumoxytol administration had positive effects on hemoglobin levels (Hedge's g statistic: 0.51) and ferritin level (0.88), transferrin saturation (0.39). Besides, we also report reduced incidence of treatment related TEAEs (-0.24) for patients consuming ferumoxytol as compared conventional iron supplement formulations.

CONCLUSIONS

This meta-analysis provides preliminary evidence that ferumoxytol use exerts beneficial effects on the overall hematological outcomes in patients with chronic kidney disease. This study also reports improved treatment related safety profile for ferumoxytol when compared with conventional iron formulations. The findings from this study can have direct implications in forming best practice guidelines for managing anemia in patients with chronic kidney disease.

摘要

目的

评估相对于传统补铁制剂,铁氧体在慢性肾脏病患者血红蛋白水平、铁蛋白水平和不良事件发生率方面的疗效。

方法

我们按照 PRISMA 指南对六个学术数据库(EMBASE、CENTRAL、Scopus、PubMed、Web of sciences 和 MEDLINE)进行了系统检索。我们对相关研究进行了荟萃分析,以评估相对于传统补铁制剂,铁氧体对慢性肾脏病患者血红蛋白水平、铁蛋白水平和与治疗相关的治疗中出现的不良事件(TEAEs)发生率的总体影响。

结果

从总共 1397 项研究中确定了 7 项符合条件的研究。这些研究包含了 3315 名慢性肾脏病患者的数据(平均年龄:59.2±4.6 岁)。荟萃分析显示,铁氧体给药对血红蛋白水平(Hedge's g 统计量:0.51)和铁蛋白水平(0.88)、转铁蛋白饱和度(0.39)有积极影响。此外,我们还报告了与传统补铁制剂相比,铁氧体治疗组的治疗相关 TEAEs 发生率降低(-0.24)。

结论

这项荟萃分析提供了初步证据,表明铁氧体的使用对慢性肾脏病患者的总体血液学结局有有益影响。与传统铁制剂相比,该研究还报告了铁氧体治疗相关安全性的改善。这项研究的结果可能对制定慢性肾脏病患者贫血管理的最佳实践指南有直接影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/833f/8856040/33ccf6d3ac5e/IRNF_A_2021237_F0001_C.jpg

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