PMID- 32042736
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220412
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 7
IP  - 23
DP  - 2019 Dec
TI  - Effectiveness of hypoxia-inducible factor prolyl hydroxylase inhibitor roxadustat 
      on renal anemia in non-dialysis-dependent chronic kidney disease: a systematic 
      review and meta-analysis.
PG  - 720
LID - 10.21037/atm.2019.12.18 [doi]
LID - 720
AB  - BACKGROUND: Renal anemia is a severe complication of chronic kidney disease (CKD) 
      and may worsen its prognosis. Roxadustat is the only oral hypoxia-inducible 
      factor prolyl hydroxylase inhibitor (HIF-PHI) that has been proved effective to 
      treat renal anemia. However, effects of roxadustat on non-dialysis-dependent CKD 
      (NDD-CKD) have yet to be supported by evidence-based medicine. METHODS: Based on 
      the databases of PubMed, EMBASE and Web of Science by 12 April 2019 
      (CRD42019133225), a meta-analysis of randomized controlled trials (RCTs) on 
      roxadustat for treatment of NDD-CKD was conducted. Primary outcomes were 
      parameters of hemoglobin (Hb) and Hb response. Secondary outcomes were hepcidin, 
      ferritin, total iron binding capacity (TIBC), transferrin saturation (TAST), 
      incidences of diarrhea, adverse events (AEs) and severe adverse events (SAEs). 
      The risk of bias and the quality of evidence were assessed, respectively. Both 
      continuous and binary variables were analyzed by the random effects models. 
      Sensitivity analyses were performed when a significant heterogeneity was observed 
      (P<0.1 and I(2)>50%). RESULTS: Finally, three studies with a total of 214 
      subjects in the roxadustat group and 80 subjects in the placebo group were 
      enrolled. An increase of Hb [weighted mean difference (WMD) =1.22, 95% CI: 0.95 
      to 1.49, P<0.01], Hb response [odds ratio (OR) =27.74, 95% CI: 10.18 to 75.62, 
      P<0.00001], and TIBC [standard mean difference (SMD) =1.59, 95% CI: 1.17 to 2.01, 
      P<0.00001] was found. A decrease of hepcidin (SMD =-4.46, 95% CI: -5.02 to -3.89, 
      P<0.00001), ferritin (WMD =-61.05, 95% CI: -85.70 to -36.40, P<0.00001) and TAST 
      (WMD =-6.55, 95% CI: -8.82 to -4.29, P<0.00001) were noted as well. Analyses of 
      incidence in diarrhea (OR =1.54, 95% CI: 0.49 to 4.79, P=0.46), AEs (OR =1.31, 
      95% CI: 0.76 to 2.27, P=0.34) and SAEs (OR =1.25, 95% CI: 0.29 to 5.35, P=0.76) 
      yielded no difference between the roxadustat and the placebo groups. CONCLUSIONS: 
      Roxadustat improved renal anemia of NDD-CKD patients by improving Hb and iron 
      metabolism. Oral administration of roxadustat was relatively safe in that 
      roxadustat did not increase the incidence of AEs and SAEs.
CI  - 2019 Annals of Translational Medicine. All rights reserved.
FAU - Jia, Linpei
AU  - Jia L
AD  - Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 
      100053, China.
FAU - Dong, Xingtong
AU  - Dong X
AD  - Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing 
      100053, China.
FAU - Yang, Jingyan
AU  - Yang J
AD  - Central Hospital of Cangzhou, Cangzhou 061001, China.
FAU - Jia, Rufu
AU  - Jia R
AD  - Central Hospital of Cangzhou, Cangzhou 061001, China.
FAU - Zhang, Hongliang
AU  - Zhang H
AD  - Department of Life Sciences, the National Natural Science Foundation of China, 
      Beijing 100085, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC6989965
OTO - NOTNLM
OT  - Roxadustat
OT  - chronic kidney disease (CKD)
OT  - hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI)
OT  - meta-analysis
OT  - renal anemia
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2020/02/12 06:00
MHDA- 2020/02/12 06:01
PMCR- 2019/12/01
CRDT- 2020/02/12 06:00
PHST- 2020/02/12 06:00 [entrez]
PHST- 2020/02/12 06:00 [pubmed]
PHST- 2020/02/12 06:01 [medline]
PHST- 2019/12/01 00:00 [pmc-release]
AID - atm-07-23-720 [pii]
AID - 10.21037/atm.2019.12.18 [doi]
PST - ppublish
SO  - Ann Transl Med. 2019 Dec;7(23):720. doi: 10.21037/atm.2019.12.18.