Department of Pharmacy, The First Affiliated Hospital of Ningbo University, Ningbo, China.
Ren Fail. 2023 Dec;45(1):2199093. doi: 10.1080/0886022X.2023.2199093.
This cohort study was designed to explore whether roxadustat or erythropoietin could affect thyroid function in patients with renal anemia.
The study involved 110 patients with renal anemia. Thyroid profile and baseline investigations were carried out for each patient. The patients were divided into two groups: 60 patients taking erythropoietin served as the control group (rHuEPO group) and 50 patients using roxadustat served as the experimental group (roxadustat group).
The results indicated that there were no significant differences in serum total thyroxine (TT4), total triiodothyronine (TT3), free triiodothyronine (FT3), free thyroxine (FT4) or thyroid stimulating hormone (TSH) between the two groups at baseline. After treatment, TSH, FT3, and FT4 were significantly lower in the roxadustat group than in the rHuEPO group ( < 0.05). After adjusting for age, sex, dialysis modality, thyroid nodules and causes of kidney disease, Cox regression showed that roxadustat was an independent influencing factor on thyroid dysfunction (HR 3.37; 95% CI 1.94-5.87; < 0.001). After 12 months of follow-up, the incidence of thyroid dysfunction was higher in the roxadustat group than in the rHuEPO group (log-rank < 0.001).
Roxadustat may lead to a higher risk of thyroid dysfunction, including low TSH, FT3 and FT4, than rHuEPO in patients with renal anemia.
本队列研究旨在探讨罗沙司他或促红细胞生成素是否会影响肾性贫血患者的甲状腺功能。
该研究纳入了 110 例肾性贫血患者。对每位患者进行甲状腺功能谱和基线检查。将患者分为两组：60 例接受促红细胞生成素治疗的患者作为对照组（rHuEPO 组），50 例使用罗沙司他的患者作为实验组（罗沙司他组）。
结果表明，两组患者在基线时的血清总甲状腺素（TT4）、总三碘甲状腺原氨酸（TT3）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH）均无显著差异。治疗后，罗沙司他组的 TSH、FT3 和 FT4 明显低于 rHuEPO 组（ < 0.05）。在校正年龄、性别、透析方式、甲状腺结节和肾脏疾病的病因后，Cox 回归显示，罗沙司他是甲状腺功能障碍的独立影响因素（HR 3.37；95%CI 1.94-5.87； < 0.001）。在 12 个月的随访后，罗沙司他组的甲状腺功能障碍发生率高于 rHuEPO 组（对数秩检验 < 0.001）。
与 rHuEPO 相比，罗沙司他可能会使肾性贫血患者发生甲状腺功能障碍（包括 TSH、FT3 和 FT4 降低）的风险更高。
