安罗替尼所致蛋白尿的发生率和总体风险的Meta分析

Incidence and risk of proteinuria induced by anlotinib:a Meta-analysis

目的系统评估安罗替尼所致蛋白尿的总体风险和发生率。方法以2021年12月为截止时间,系统检索PubMed、Cochrane Library、Embase、中国知网(CNKI)、维普数据库(VIP)、万方数据库(Wanfang Data)、中国生物医学文献数据库(CBM)等国内外相关数据库,提取符合纳入标准的临床随机对照试验(RCT)。分析纳入研究的异质性,通过固定或随机效应模型统计发生率、相对风险(RR)和95%置信区间(CI)。结果纳入7项RCT研究共1302例患者,其中观察组所有级别和高级别蛋白尿的发生数分别为272例和27例,对照组的发生数则分别为61例和4例。经分析,使用安罗替尼所有级别和高级别蛋白尿的发生率分别为25.8%(95%CI:16.1%~35.6%)和2.3%(95%CI:0.5%~4.9%)。与对照组相比,安罗替尼增加了所有级别(RR=2.251,95%CI:1.750~2.896,P<0.010)和高级别蛋白尿(RR=3.470,95%CI:1.180~10.220,P=0.024)的发生风险。结论安罗替尼增加了癌症患者蛋白尿的发生风险和发生率,建议密切监测和有效管理安罗替尼所引起的蛋白尿。

Objective To systematically evaluate the overall risk and incidence of proteinuria induced by anlotinib.Methods With December 2021 as the deadline,the databases were systematically searched,including PubMed,Cochrane Library,Embase,CNKI,VIP,Wanfang Data,China Biomedical Literature(CBM)and other relevant databases at home and abroad,and RCT meeting the inclusion criteria was extracted.The heterogeneity of the included studies was analyzed,and the incidence,relative risk(RR)and 95%confidence interval(CI)were calculated through fixed or random effect models.Results A total of 1302 patients were included in 7 RCT studies.The number of all-grade and high-grade proteinuria in the observation group was 272 cases and 27 cases respectively,while that in the control group was 61 and 4 cases respectively.After analysis,the incidence of all-grade and high-grade proteinuria was 25.8%(95%CI:16.1%~35.6%)and 2.3%(95%CI:0.5%~4.9%)respectively after using anlotinib.Compared with the control group,anlotinib could increase the risk of all-grade(RR=2.251,95%CI:1.750~2.896,P<0.010)and high-grade proteinuria(RR=3.470,95%CI:1.180~10.220,P=0.024).Conclusion Anlotinib increases the risk and incidence of proteinuria in cancer patients.Close monitoring and effective management are recommended for the proteinuria caused by anlotinib.