Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Abeno-ku, Osaka, Japan.
Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Abeno-ku, Osaka, Japan.
Transplant Proc. 2024 Apr;56(3):534-539. doi: 10.1016/j.transproceed.2024.01.016. Epub 2024 Feb 13.
Daprodustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor, has been reported to be effective in treating conservative renal failure and renal anemia in patients undergoing dialysis. However, its effects on post-transplant anemia have not yet been reported. This study aimed to determine whether daprodustat may be a useful treatment for post-transplant anemia.
Excluding 5 cases in which the drug was discontinued due to side effects, 21 post-transplant patients treated with daprodustat for ≥12 months and available for follow-up were analyzed. Changes in hemoglobin levels, iron metabolism, estimated glomerular filtration rate, and low-density lipoprotein levels were evaluated over 1 year.
The average hemoglobin level was 10.1 g/dL before treatment, and after 1, 2, 3, 6, 9, and 12 months, these had increased significantly to 10.9, 11.2, 11.9, 12.3, 12.3, and 12.6, respectively. Ferritin levels were significantly lower throughout the 12-month study period. Transferrin saturation was significantly lower than before treatment during the first 6 months, with no significant differences after that. The participants' estimated glomerular filtration rate and low-density lipoprotein cholesterol levels did not change significantly throughout the treatment.
Daprodustat significantly increased hemoglobin levels was easily dose-adjusted and was relatively safe for continuous use over 1 year. It was also effective in patients who had responded inadequately to erythropoiesis-stimulating agents. Therefore, we conclude that daprodustat may be a useful treatment for post-transplant anemia.
达普司他是一种低氧诱导因子脯氨酰羟化酶抑制剂,已被报道可有效治疗透析患者的保守性肾衰竭和肾性贫血。然而,其对移植后贫血的影响尚未报道。本研究旨在确定达普司他是否可作为治疗移植后贫血的一种有效药物。
排除因副作用而停药的 5 例患者,对接受达普司他治疗≥12 个月且可随访的 21 例移植后患者进行分析。在 1 年内评估血红蛋白水平、铁代谢、估算肾小球滤过率和低密度脂蛋白水平的变化。
治疗前平均血红蛋白水平为 10.1 g/dL,治疗后 1、2、3、6、9 和 12 个月时,血红蛋白水平分别显著增加至 10.9、11.2、11.9、12.3、12.3 和 12.6。整个 12 个月的研究期间,铁蛋白水平显著降低。转铁蛋白饱和度在治疗的前 6 个月显著低于治疗前,此后无显著差异。参与者的估算肾小球滤过率和低密度脂蛋白胆固醇水平在整个治疗过程中无明显变化。
达普司他显著升高血红蛋白水平,且易于调整剂量,连续使用 1 年以上相对安全。对促红细胞生成素反应不足的患者也有效。因此,我们得出结论,达普司他可能是治疗移植后贫血的一种有效药物。