Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients
Hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) are orally active first-in-class new generation drugs for renal anemia. This extensive meta-analysis of randomized controlled trials (RCTs) was designed to provide clear information on the efficacy and safety of HIF-PHIs on anemia in...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-01-01
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| Series: | Renal Failure |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/0886022X.2020.1811121 |
| _version_ | 1818615071844073472 |
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| author | Bin Wang Qing Yin Yu-Chen Han Min Wu Zuo-Lin Li Yan Tu Le-ting Zhou Qing Wei Hong Liu Ri-Ning Tang Jing-Yuan Cao Lin-Li Lv Bi-Cheng Liu |
| author_facet | Bin Wang Qing Yin Yu-Chen Han Min Wu Zuo-Lin Li Yan Tu Le-ting Zhou Qing Wei Hong Liu Ri-Ning Tang Jing-Yuan Cao Lin-Li Lv Bi-Cheng Liu |
| author_sort | Bin Wang |
| collection | DOAJ |
| description | Hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) are orally active first-in-class new generation drugs for renal anemia. This extensive meta-analysis of randomized controlled trials (RCTs) was designed to provide clear information on the efficacy and safety of HIF-PHIs on anemia in chronic kidney disease (CKD) patients. Searches included PubMed, Web of Science, Ovid MEDLINE, and Cochrane Library database up to October 2019. RCTs of patients with CKD comparing HIF-PHIs with erythropoiesis-stimulating agents (ESAs) or placebo in the treatment of anemia. The primary outcome was hemoglobin change from baseline (Hb CFB); the secondary outcomes included iron-related parameters and the occurrence of each adverse event. 26 trials in 17 articles were included, with a total of 2804 dialysis or patients with CKD. HIF-PHIs treatment produced a significant beneficial effect on Hb CFB compared with the placebo group (MD, 0.69; 95% CI, 0.36 to 1.02). However, this favored effect of HIF-PHIs treatment was not observed in subgroup analysis among trials compared with ESAs (MD, 0.06; 95% CI, −0.20 to 0.31). The significant reduction in hepcidin by HIF-PHIs was observed in all subgroups when compared with the placebo group, whereas this effect was observed only in NDD-CKD patients when compared with ESAs. HIF-PHIs increased the risk of nausea (RR, 2.20; 95% CI, 1.06 to 4.53) and diarrhea (RR, 1.75; 95% CI, 1.06 to 2.92). We conclude that orally given HIF-PHIs are at least as efficacious as ESAs treatment to correct anemia short term in patients with CKD. In addition, HIF-PHIs improved iron metabolism and utilization in patients with CKD. |
| first_indexed | 2024-12-16T16:28:05Z |
| format | Article |
| id | doaj.art-cfe722a3ee6a4ebc8b7cf6d8db4e421f |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-12-16T16:28:05Z |
| publishDate | 2020-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-cfe722a3ee6a4ebc8b7cf6d8db4e421f2022-12-21T22:24:40ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492020-01-0142191292510.1080/0886022X.2020.18111211811121Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patientsBin Wang0Qing Yin1Yu-Chen Han2Min Wu3Zuo-Lin Li4Yan Tu5Le-ting Zhou6Qing Wei7Hong Liu8Ri-Ning Tang9Jing-Yuan Cao10Lin-Li Lv11Bi-Cheng Liu12Institute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineDepartment of Nephrology, Wuxi People’s HospitalInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineInstitute of Nephrology, Zhong Da Hospital, Southeast University School of MedicineHypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) are orally active first-in-class new generation drugs for renal anemia. This extensive meta-analysis of randomized controlled trials (RCTs) was designed to provide clear information on the efficacy and safety of HIF-PHIs on anemia in chronic kidney disease (CKD) patients. Searches included PubMed, Web of Science, Ovid MEDLINE, and Cochrane Library database up to October 2019. RCTs of patients with CKD comparing HIF-PHIs with erythropoiesis-stimulating agents (ESAs) or placebo in the treatment of anemia. The primary outcome was hemoglobin change from baseline (Hb CFB); the secondary outcomes included iron-related parameters and the occurrence of each adverse event. 26 trials in 17 articles were included, with a total of 2804 dialysis or patients with CKD. HIF-PHIs treatment produced a significant beneficial effect on Hb CFB compared with the placebo group (MD, 0.69; 95% CI, 0.36 to 1.02). However, this favored effect of HIF-PHIs treatment was not observed in subgroup analysis among trials compared with ESAs (MD, 0.06; 95% CI, −0.20 to 0.31). The significant reduction in hepcidin by HIF-PHIs was observed in all subgroups when compared with the placebo group, whereas this effect was observed only in NDD-CKD patients when compared with ESAs. HIF-PHIs increased the risk of nausea (RR, 2.20; 95% CI, 1.06 to 4.53) and diarrhea (RR, 1.75; 95% CI, 1.06 to 2.92). We conclude that orally given HIF-PHIs are at least as efficacious as ESAs treatment to correct anemia short term in patients with CKD. In addition, HIF-PHIs improved iron metabolism and utilization in patients with CKD.http://dx.doi.org/10.1080/0886022X.2020.1811121hif-phisrenal anemiachronic kidney diseasemeta-analysis |
| spellingShingle | Bin Wang Qing Yin Yu-Chen Han Min Wu Zuo-Lin Li Yan Tu Le-ting Zhou Qing Wei Hong Liu Ri-Ning Tang Jing-Yuan Cao Lin-Li Lv Bi-Cheng Liu Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients Renal Failure hif-phis renal anemia chronic kidney disease meta-analysis |
| title | Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients |
| title_full | Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients |
| title_fullStr | Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients |
| title_full_unstemmed | Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients |
| title_short | Effect of hypoxia-inducible factor-prolyl hydroxylase inhibitors on anemia in patients with CKD: a meta-analysis of randomized controlled trials including 2804 patients |
| title_sort | effect of hypoxia inducible factor prolyl hydroxylase inhibitors on anemia in patients with ckd a meta analysis of randomized controlled trials including 2804 patients |
| topic | hif-phis renal anemia chronic kidney disease meta-analysis |
| url | http://dx.doi.org/10.1080/0886022X.2020.1811121 |
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