Jiang Luhua, Jia Ruoyu, Zheng Zhifang, Zhang Xuejie, Xu Yizhou, Raj Ashok, Sun Dong
Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China.
National Clinical Research Center of Kidney Diseases, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, 210002, China.
Int Urol Nephrol. 2024 Mar;56(3):1093-1101. doi: 10.1007/s11255-023-03757-0. Epub 2023 Aug 25.
The development of roxadustat is a standard treatment for renal anemia, and multiple clinical trials have proved its safety and efficacy. However, less information is available from trials of the population with diabetic nephropathy (DN). This study aimed to determine whether roxadustat is effective for treating DN.
This was a single-center, retrospective, institutional review board-approved cohort study. The patients with DN were chosen and given roxadustat or erythropoietin (EPO) for 8 weeks. The mean hemoglobin (Hb) level after 8 weeks of treatment served as the primary outcome. Alterations in the iron index and lipid levels were considered secondary objectives. Sub-group analysis was performed to observe the impact of inflammation and glycemic status on Hb.
A total of 80 patients were enrolled, 40 in each group. After 8 weeks of treatment, the Hb levels in the roxadustat group were higher than those in the control group. The number of patients who achieved Hb response was higher in the roxadustat group than in the control group (77.5% versus 27.5%; P < 0.001). In addition to lowering total cholesterol and low-density lipoprotein cholesterol, roxadustat decreased ferritin and elevated total iron-binding capacity. Compared to the control group, roxadustat was more beneficial for patients with an inflammatory condition and poor glycemic control.
Roxadustat treatment remarkably corrected anemia in patients with DN, and its effectiveness was unaffected by inflammation or glycemic control levels. In addition, roxadustat can also reduce a patient's blood lipid level and enhance the body's use of iron.
ChiCTR2200057232.
罗沙司他的研发是肾性贫血的标准治疗方法,多项临床试验已证明其安全性和有效性。然而,关于糖尿病肾病(DN)患者群体的试验信息较少。本研究旨在确定罗沙司他治疗DN是否有效。
这是一项经机构审查委员会批准的单中心回顾性队列研究。选择DN患者并给予罗沙司他或促红细胞生成素(EPO)治疗8周。治疗8周后的平均血红蛋白(Hb)水平作为主要结局。铁指标和血脂水平的变化被视为次要目标。进行亚组分析以观察炎症和血糖状态对Hb的影响。
共纳入80例患者,每组40例。治疗8周后,罗沙司他组的Hb水平高于对照组。罗沙司他组达到Hb反应的患者数量高于对照组(77.5%对27.5%;P < 0.001)。除降低总胆固醇和低密度脂蛋白胆固醇外,罗沙司他还降低了铁蛋白并提高了总铁结合力。与对照组相比,罗沙司他对炎症状态和血糖控制不佳的患者更有益。
罗沙司他治疗显著纠正了DN患者的贫血,其有效性不受炎症或血糖控制水平的影响。此外,罗沙司他还可降低患者的血脂水平并增强机体对铁的利用。
ChiCTR2200057232。