Efficacy of AST-120 for Patients With Chronic Kidney Disease: A Network Meta-Analysis of Randomized Controlled Trials
AST-120, an oral spherical activated carbon, may delay the need for kidney dialysis and improve uremia symptoms because it can adsorb acidic and basic organic compounds, especially small-molecule uremic toxins. However, previous studies produced no conclusive evidence regarding the benefits of AST-1...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2021.676345/full |
| _version_ | 1819087097049382912 |
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| author | Pei-Yu Su Pei-Yu Su Ya-Han Lee Ya-Han Lee Li-Na Kuo Li-Na Kuo Yen-Cheng Chen Yen-Cheng Chen Chiehfeng Chen Chiehfeng Chen Chiehfeng Chen Chiehfeng Chen Yi-No Kang Yi-No Kang Yi-No Kang Yi-No Kang Elizabeth H. Chang Elizabeth H. Chang Elizabeth H. Chang |
| author_facet | Pei-Yu Su Pei-Yu Su Ya-Han Lee Ya-Han Lee Li-Na Kuo Li-Na Kuo Yen-Cheng Chen Yen-Cheng Chen Chiehfeng Chen Chiehfeng Chen Chiehfeng Chen Chiehfeng Chen Yi-No Kang Yi-No Kang Yi-No Kang Yi-No Kang Elizabeth H. Chang Elizabeth H. Chang Elizabeth H. Chang |
| author_sort | Pei-Yu Su |
| collection | DOAJ |
| description | AST-120, an oral spherical activated carbon, may delay the need for kidney dialysis and improve uremia symptoms because it can adsorb acidic and basic organic compounds, especially small-molecule uremic toxins. However, previous studies produced no conclusive evidence regarding the benefits of AST-120 in delaying the progression of chronic kidney disease (CKD). Therefore, this systematic review and network meta-analysis evaluated the effects of AST-120 in patients with CKD. Related keywords of CKD and AST-120 were used to search four databases to obtain potential evidence on this topic, and two authors individually completed evidence selection, data extraction, and quality assessment. Network meta-analysis was performed for mortality, end-stage renal disease, composite renal outcomes, and laboratory outcomes based on a frequentist approach. In total, 15 randomized controlled trials (n = 3,763) were included in the present synthesis, and the pooled results revealed non-significant differences in mortality among the treatment strategies. Low- and high-dose AST-120 were not superior to no AST-120 treatment regarding renal outcomes. However, the event rates of end-stage renal disease (risk ratio [RR] = 0.78, 95% confidence interval [CI] = 0.62–0.99) and composite renal outcomes (RR = 0.78, 95% CI: 0.63–0.97) were significantly lower in the tailored-dose AST-120 group than in no AST-120 group. The results did not reveal a small-study effect on the outcomes. Tailored dosing of AST-120 appeared to represent an optimal treatment strategy because it resulted in lower rates of composite renal outcomes and end-stage renal disease. |
| first_indexed | 2024-12-21T21:30:43Z |
| format | Article |
| id | doaj.art-1622ad7e17eb447fbd09224c93a3735f |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-21T21:30:43Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-1622ad7e17eb447fbd09224c93a3735f2022-12-21T18:49:37ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-07-011210.3389/fphar.2021.676345676345Efficacy of AST-120 for Patients With Chronic Kidney Disease: A Network Meta-Analysis of Randomized Controlled TrialsPei-Yu Su0Pei-Yu Su1Ya-Han Lee2Ya-Han Lee3Li-Na Kuo4Li-Na Kuo5Yen-Cheng Chen6Yen-Cheng Chen7Chiehfeng Chen8Chiehfeng Chen9Chiehfeng Chen10Chiehfeng Chen11Yi-No Kang12Yi-No Kang13Yi-No Kang14Yi-No Kang15Elizabeth H. Chang16Elizabeth H. Chang17Elizabeth H. Chang18Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanDepartment of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, TaiwanDepartment of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanDepartment of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, TaiwanDepartment of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanDepartment of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, TaiwanDepartment of Internal Medicine, Division of Nephrology, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanSchool of Medicine, College of Medicine, Taipei Medical University, Taipei, TaiwanCochrane Taiwan, Taipei Medical University, Taipei, TaiwanEvidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanDepartment of Surgery, Division of Plastic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanDepartment of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, TaiwanCochrane Taiwan, Taipei Medical University, Taipei, TaiwanEvidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanResearch Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan0Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, TaiwanDepartment of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanDepartment of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan1Research Center for Pharmacoeconomics, College of Pharmacy, Taipei Medical University, Taipei, TaiwanAST-120, an oral spherical activated carbon, may delay the need for kidney dialysis and improve uremia symptoms because it can adsorb acidic and basic organic compounds, especially small-molecule uremic toxins. However, previous studies produced no conclusive evidence regarding the benefits of AST-120 in delaying the progression of chronic kidney disease (CKD). Therefore, this systematic review and network meta-analysis evaluated the effects of AST-120 in patients with CKD. Related keywords of CKD and AST-120 were used to search four databases to obtain potential evidence on this topic, and two authors individually completed evidence selection, data extraction, and quality assessment. Network meta-analysis was performed for mortality, end-stage renal disease, composite renal outcomes, and laboratory outcomes based on a frequentist approach. In total, 15 randomized controlled trials (n = 3,763) were included in the present synthesis, and the pooled results revealed non-significant differences in mortality among the treatment strategies. Low- and high-dose AST-120 were not superior to no AST-120 treatment regarding renal outcomes. However, the event rates of end-stage renal disease (risk ratio [RR] = 0.78, 95% confidence interval [CI] = 0.62–0.99) and composite renal outcomes (RR = 0.78, 95% CI: 0.63–0.97) were significantly lower in the tailored-dose AST-120 group than in no AST-120 group. The results did not reveal a small-study effect on the outcomes. Tailored dosing of AST-120 appeared to represent an optimal treatment strategy because it resulted in lower rates of composite renal outcomes and end-stage renal disease.https://www.frontiersin.org/articles/10.3389/fphar.2021.676345/fullchronic renal failureadsorbentkremezinuremic toxinsorbent |
| spellingShingle | Pei-Yu Su Pei-Yu Su Ya-Han Lee Ya-Han Lee Li-Na Kuo Li-Na Kuo Yen-Cheng Chen Yen-Cheng Chen Chiehfeng Chen Chiehfeng Chen Chiehfeng Chen Chiehfeng Chen Yi-No Kang Yi-No Kang Yi-No Kang Yi-No Kang Elizabeth H. Chang Elizabeth H. Chang Elizabeth H. Chang Efficacy of AST-120 for Patients With Chronic Kidney Disease: A Network Meta-Analysis of Randomized Controlled Trials Frontiers in Pharmacology chronic renal failure adsorbent kremezin uremic toxin sorbent |
| title | Efficacy of AST-120 for Patients With Chronic Kidney Disease: A Network Meta-Analysis of Randomized Controlled Trials |
| title_full | Efficacy of AST-120 for Patients With Chronic Kidney Disease: A Network Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Efficacy of AST-120 for Patients With Chronic Kidney Disease: A Network Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Efficacy of AST-120 for Patients With Chronic Kidney Disease: A Network Meta-Analysis of Randomized Controlled Trials |
| title_short | Efficacy of AST-120 for Patients With Chronic Kidney Disease: A Network Meta-Analysis of Randomized Controlled Trials |
| title_sort | efficacy of ast 120 for patients with chronic kidney disease a network meta analysis of randomized controlled trials |
| topic | chronic renal failure adsorbent kremezin uremic toxin sorbent |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2021.676345/full |
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