Efficacy and safety of daprodustat versus darbepoetin alfa in the treatment of anemia in chronic renal failure: Systematic review and meta-analysis of randomized controlled trials

Abstract

Objectives

To compare the efficacy and safety of daprodustat (DPD) versus darbepoetin alfa (DBPA) in patients with anemia in chronic renal failure.

Materials and methods

Randomized controlled trials (RCTs) of DPD and DBPA in anemia were retrieved from PubMed, Embase, Cochrane library, and Web of Science from inception to August 1, 2023. The collected data were analyzed using Stata 15.0.

Results

Four RCTs involving 7419 patients (3717 in the DPD group and 3702 in the DBPA group) were included in the study. Meta-analysis revealed that there were no significant differences in the change in hemoglobin level [Standardized Mean Difference (SMD) = 3.23, 95 % CI (−0.25, 6.70)], transferrin saturation [SMD = −0.07, 95 % CI (−0.31, 0.17)], total iron [SMD = 0.24, 95 % CI (−0.05, 0.53))], and incidence of adverse events [ RR = 1.02, 95 % CI (0.98, 1.06)] between the two groups. However, DPD was superior in lowering ferritin level [SMD = −0.05, 95 % CI (−0.10, −0.01)] and improving total iron-binding capacity [SMD = 0.57, 95 % CI (0.46, 0.68)] than DBPA.

Conclusions

DPD is not inferior to DBPA in the treatment of anemia in chronic renal failure.