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罗沙司他治疗移植后贫血的疗效和安全性:一项随机研究。

The Efficacy and Safety of Roxadustat for the Treatment of Posttransplantation Anemia: A Randomized Study.

作者信息

Kong Weiwei, Wu Xiaoying, Shen Zhuowei, Wang Meifang, Liu Xinyu, Lin Xiaoli, Qiu Yingyin, Jiang Hong, Chen Jianghua, Lou Yan, Huang Hongfeng

机构信息

Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province; Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou, Zhejiang, China.

Zhejiang Provincial Key Laboratory for Drug Clinical Research and Evaluation, Department of Clinical Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

出版信息

Kidney Int Rep. 2024 Apr 15;9(6):1705-1717. doi: 10.1016/j.ekir.2024.04.021. eCollection 2024 Jun.

Abstract

INTRODUCTION

Roxadustat, an oral hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitor, can stimulate erythropoiesis. Our objective was to evaluate the efficacy and safety of roxadustat for the treatment of posttransplantation anemia (PTA).

METHODS

A total of 150 adult renal transplant recipients who underwent PTA were randomized to either the experimental group or the control group. During the 12-week randomized phase, the experimental group was randomized to oral iron and roxadustat treatment, and the control group was randomized to oral iron treatment only. The randomized phase was followed by a 12-week extended treatment period in which all participants were prescribed roxadustat treatment according to hemoglobin (Hb) levels. All the participants were followed-up with every 4 weeks. The primary end points were the change in Hb levels and response rate throughout the randomized period.

RESULTS

A total of 128 participants completed the randomized treatment period (90 in the experimental group and 38 in the control group). The mean Hb concentration at week 12 was 12.20 g/dl in the experimental group and 11.19 g/dl in the control group. A significantly higher proportion of participants who achieved Hb responses were in the experimental group than in the control group. Differences in serum iron, total iron-binding capacity (TIBC) and transferrin from baseline to week 8 to 12 were significant between the 2 groups. The adverse event profiles were comparable between the 2 groups.

CONCLUSION

Roxadustat increased Hb in adult renal transplant recipients who underwent PTA, with an adverse event profile comparable to that of the control group.

摘要

引言

罗沙司他是一种口服的缺氧诱导因子脯氨酰羟化酶(HIF-PH)抑制剂,可刺激红细胞生成。我们的目的是评估罗沙司他治疗移植后贫血(PTA)的疗效和安全性。

方法

总共150例发生PTA的成年肾移植受者被随机分为实验组或对照组。在为期12周的随机阶段,实验组被随机分配接受口服铁剂和罗沙司他治疗,对照组则仅接受口服铁剂治疗。随机阶段之后是为期12周的延长治疗期,在此期间,所有参与者根据血红蛋白(Hb)水平接受罗沙司他治疗。所有参与者每4周接受一次随访。主要终点是整个随机阶段Hb水平的变化和缓解率。

结果

共有128名参与者完成了随机治疗阶段(实验组90名,对照组38名)。实验组在第12周时的平均Hb浓度为12.20 g/dl,对照组为11.19 g/dl。达到Hb缓解的参与者比例在实验组中显著高于对照组。两组之间从基线到第8至12周的血清铁、总铁结合力(TIBC)和转铁蛋白差异显著。两组的不良事件情况相当。

结论

罗沙司他可提高发生PTA的成年肾移植受者的Hb水平,其不良事件情况与对照组相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5aaa/11184400/0475ac6c6474/ga1.jpg

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