罗沙司他治疗肾脏透析患者贫血有效性和安全性的Meta分析

Efficacy and safety of Roxadustat on anemia in patients undergoing renal dialysis: a Meta-analysis

目的:探讨罗沙司他治疗肾脏透析患者贫血的疗效和安全性。方法:检索PubMed、Embase、Web of Science、Cochrane Library、Scopus、万方、CNKI、维普、CBM数据库,时间为建库至2020年6月。纳入罗沙司他治疗贫血的随机对照试验,提取资料并应用RevMan 5.3软件进行Meta分析。结果:纳入4项研究共847例患者。分析结果显示,与对照组相比,罗沙司他可有效提高患者血红蛋白达标率(RR=1.24,95%CI 1.01~1.53,P=0.04),但对血红蛋白水平的增加,两组无统计学差异(WMD=0.03 g·dL-1,95%CI-0.09~0.16,P=0.61)。此外,罗沙司他显著提高转铁蛋白饱和度。在治疗患者贫血的过程中,罗沙司他组的不良事件发生率高于对照组。结论:罗沙司他可有效提高患者血红蛋白达标率,增加铁利用,改善患者的肾性贫血症状,但其安全性问题仍需广泛关注。

OBJECTIVE To evaluate the efficacy and safety of Roxadustat on anemia in patients undergoing renal dialysis.METHODS PubMed, Embase, Web of Science, Cochrane Library, Scopus, Wanfang, CNKI, VIP, and CBM databases were searched from inception to June 2020. Randomized controlled trials of Roxadustat in the treatment of anemia were included, data were extracted and meta-analysis was performed using RevMan 5.3 software.RESULTS A total of 4 studies with 847 patients were included. Meta-analysis results revealed that Roxadustat significantly increased the standard-reaching rate of hemoglobin in patients undergoing renal dialysis(RR=1.24, 95% CI 1.01-1.53, P=0.04). However, no statistically difference in the change levels of hemoglobin was observed between Roxadustat group and control group(WMD=0.03 g·dL-1, 95% CI-0.09-0.16, P=0.61). Moreover, compared with the control group, the level of transferrin saturation was markedly elevated in Roxadustat group. During the treatment of anemia in dialysis patients, the incidence of adverse events in the Roxadustat group was higher than that in the control group.CONCLUSION Roxadustat can effectively improve the hemoglobin compliance rate, increase iron utilization and improve the symptoms of renal anemia, but its safety still needs extensive attention.