PMID- 37292157
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230611
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 14
DP  - 2023
TI  - Safety of HIF prolyl hydroxylase inhibitors for anemia in dialysis patients: a 
      systematic review and network meta-analysis.
PG  - 1163908
LID - 10.3389/fphar.2023.1163908 [doi]
LID - 1163908
AB  - Aim: We performed a systematic review and network meta-analysis evaluating the 
      safety and efficacy of hypoxia-inducible factor prolyl hydroxylase inhibitors 
      (HIF-PHIs) among dialysis chronic kidney disease patients. Methods: Safety was 
      evaluated with any adverse events (AEs), serious adverse events (SAEs), and 12 
      common events. Efficacy was mainly analyzed with hemoglobin response. All 
      reported results were summarized using mean difference and risk ratio (RR) with 
      95% confidence interval (CI). Publication bias was assessed through funnel plots. 
      Results: Twenty trials (19 studies) with 14,947 participants were included, 
      comparing six HIF-PHIs with erythropoiesis-stimulating agents (ESAs). No 
      significant differences were indicated in overall AEs and SAEs between each 
      HIF-PHI and ESA. The occurrence of gastrointestinal disorder was higher in 
      enarodustat and roxadustat than in ESAs (RR: 6.92, 95% CI: 1.52-31.40, p = 0.01; 
      RR: 1.30, 95% CI: 1.04-1.61, p = 0.02). The occurrence of hypertension was lower 
      in vadadustat than in ESAs (RR: 0.81, 95% CI: 0.69-0.96, p = 0.01). The 
      occurrence of vascular-access complications was higher in roxadustat (RR: 1.15, 
      95% CI: 1.04-1.27, p<0.01) and lower in daprodustat (RR: 0.78, 95% CI: 0.66-0.92, 
      p<0.01) than in ESAs. In the risk of the other nine events, including 
      cardiovascular events, no significant differences were observed between HIF-PHIs 
      and ESAs. For hemoglobin response, network meta-analysis showed that compared 
      with ESAs, significant increases were shown in roxadustat (RR: 1.04, 95% CI: 
      1.01-1.07, p<0.01) and desidustat (RR: 1.22, 95% CI: 1.01-1.48, p = 0.04), 
      whereas noticeable reductions were indicated in vadadustat (RR: 0.88, 95% CI: 
      0.82-0.94, p<0.01) and molidustat (RR: 0.83, 95% CI: 0.70-0.98, p = 0.02). There 
      was no significant difference between daprodustat and ESAs (RR: 0.97, 95% CI: 
      0.89-1.06, p = 0.47). Conclusion: Although HIF-PHIs did not show significant 
      differences from ESAs in terms of overall AEs and SAEs, statistical differences 
      in gastrointestinal disorder, hypertension, and vascular-access complications 
      were observed between HIF-PHIs, which deserved to be noted in clinical decision 
      making. Systematic review registration: This study is registered with PROSPERO 
      (registration number CRD42022312252).
CI  - Copyright (c) 2023 Chen, Niu, Liu, Yang, Wang, Li and Chen.
FAU - Chen, Dinghua
AU  - Chen D
AD  - Department of Nephrology, First Medical Center of Chinese PLA General Hospital, 
      Beijing, China.
FAU - Niu, Yue
AU  - Niu Y
AD  - Department of Nephrology, First Medical Center of Chinese PLA General Hospital, 
      Beijing, China.
FAU - Liu, Fei
AU  - Liu F
AD  - Department of Urology, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, China.
FAU - Yang, Yue
AU  - Yang Y
AD  - Department of Nephrology, First Medical Center of Chinese PLA General Hospital, 
      Beijing, China.
FAU - Wang, Xue
AU  - Wang X
AD  - Department of Nephrology, First Medical Center of Chinese PLA General Hospital, 
      Beijing, China.
FAU - Li, Ping
AU  - Li P
AD  - Department of Nephrology, First Medical Center of Chinese PLA General Hospital, 
      Beijing, China.
FAU - Chen, Xiangmei
AU  - Chen X
AD  - Department of Nephrology, First Medical Center of Chinese PLA General Hospital, 
      Beijing, China.
LA  - eng
PT  - Systematic Review
DEP - 20230524
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC10244523
OTO - NOTNLM
OT  - adverse event
OT  - anemia
OT  - chronic kidney disease
OT  - erythropoiesis-stimulating agent
OT  - hypoxia-inducible factor prolyl hydroxylase inhibitors
OT  - renal dialysis
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/06/09 06:42
MHDA- 2023/06/09 06:43
PMCR- 2023/05/24
CRDT- 2023/06/09 04:17
PHST- 2023/02/11 00:00 [received]
PHST- 2023/05/09 00:00 [accepted]
PHST- 2023/06/09 06:43 [medline]
PHST- 2023/06/09 06:42 [pubmed]
PHST- 2023/06/09 04:17 [entrez]
PHST- 2023/05/24 00:00 [pmc-release]
AID - 1163908 [pii]
AID - 10.3389/fphar.2023.1163908 [doi]
PST - epublish
SO  - Front Pharmacol. 2023 May 24;14:1163908. doi: 10.3389/fphar.2023.1163908. 
      eCollection 2023.