Fadlalmola Hammad, Al-Sayaghi Khaled, Al-Hebshi Abdulqader, Aljohani Maher, Albalawi Mohammed, Kashari Ohoud, Alem Alaa, Alrasheedy Mariam, Balelah Saud, Almuteri Faten, Alyamani Arwa, Alwasaidi Turki
Department of Community Health Nursing, College of Nursing, Taibah University, Al-Madinah Al-Munawarah and KSA 1, Medina 42353, Saudi Arabia.
Department of Medical Surgical Nursing, College of Nursing, Taibah University, Al-Madinah Al-Munawarah, KSA 1, Medina 42353, Saudi Arabia.
J Clin Med. 2022 May 11;11(10):2722. doi: 10.3390/jcm11102722.
(1) Background: Anemia affects about 40% of patients with chronic kidney disease (CKD). Daprodustat improves serum hemoglobin in anemic patients by inhibiting prolyl hydroxylase of hypoxia-inducible factor. We conducted a network meta-analysis to investigate the direct and indirect effects of different doses of daprodustat compared to each other and erythropoietin and placebo. (2) Methods: We searched PubMed, Cochrane Library, Web of Science, and Scopus, for randomized clinical trials (RCTs) reporting data about different doses of daprodustat for anemia in nondialysis of CKDs. (3) Results: We eventually included five RCTs with a total sample size of 4566 patients. We found that the higher the dose of daprodustat, the greater the change in serum total iron binding capacity (TIBC), hemoglobin, and ferritin from baseline. Compared to placebo, daprodustat 25-30 mg was associated with the highest significant increase in serum hemoglobin (MD = 3.27, 95% CI = [1.89; 4.65]), a decrease in serum ferritin (MD = -241.77, 95% CI = [-365.45; -118.09]) and increase in serum TIBC (MD = 18.52, 95% CI = [12.17; 24.87]). (4) Conclusion: Higher daprodustat doses were associated with a higher impact on efficacy outcomes as serum total iron-binding capacity (TIBC), hemoglobin, and ferritin. However, data about the safety profile of different doses of daprodustat is still missing.
(1) 背景：贫血影响约40%的慢性肾脏病（CKD）患者。达泊西汀通过抑制缺氧诱导因子的脯氨酰羟化酶来提高贫血患者的血清血红蛋白水平。我们进行了一项网状荟萃分析，以研究不同剂量的达泊西汀相互之间以及与促红细胞生成素和安慰剂相比的直接和间接效应。(2) 方法：我们检索了PubMed、Cochrane图书馆、科学网和Scopus，以查找报告慢性肾脏病非透析患者不同剂量达泊西汀治疗贫血数据的随机临床试验（RCT）。(3) 结果：我们最终纳入了五项RCT，总样本量为4566例患者。我们发现，达泊西汀剂量越高，血清总铁结合力（TIBC）、血红蛋白和铁蛋白相对于基线的变化就越大。与安慰剂相比，25 - 30 mg的达泊西汀与血清血红蛋白的最高显著增加相关（MD = 3.27，95%CI = [1.89; 4.65]），血清铁蛋白降低（MD = -241.77，95%CI = [-365.45; -118.09]），血清TIBC升高（MD = 18.52，95%CI = [12.17; 24.87]）。(4) 结论：较高剂量的达泊西汀对血清总铁结合力（TIBC）、血红蛋白和铁蛋白等疗效指标的影响更大。然而，关于不同剂量达泊西汀安全性的资料仍然缺失。
