蔗糖铁氧氢氧化物与碳酸司维拉姆的疗效和安全性对比:系统回顾和荟萃分析。

Christos Georgopoulos, Anila Duni, Eleni Stamellou, Athanasios Kitsos, Charikleia Gouva, Evangelia Dounousi
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引用次数: 0

摘要

简介:磷酸盐结合剂常用于接受肾脏替代疗法(KRT)的患者,旨在降低和维持血清磷。慢性肾病-矿物质和骨骼紊乱与寿命缩短和生活质量下降有关。本研究旨在探讨蔗糖铁氧氢氧化物与碳酸司维拉姆在接受 KRT 治疗的患者中的疗效和安全性:研究数据来源于 MEDLINE (PubMed)、Scopus 和 Cochrane Central Register of Controlled Clinical Trials,搜索截止日期为 2023 年 10 月。我们研究了在接受 KRT 的成人中比较蔗糖铁氧氢氧化物与碳酸司维拉姆的随机对照试验。我们使用 R-studio.Findings 对试验数据进行了荟萃分析:五项随机试验均符合纳入标准。两组试验在降低血清磷方面无统计学差异(MD:-0.07 mmol/L,95% CI-随机效应:-0.15 至 0.02)。同样,观察到两种药物在降低血清 i-PTH 方面存在无统计学意义的差异(MD = -1.53 mg/dL,95% CI = (-4.45, 1.4),p = 0.26,随机效应模型)。在所有不良事件中,两组之间未观察到有统计学意义的差异(几率比:1.11,95% CI:0.65-1.88,随机效应模型)。对胃肠道不良事件的进一步分析显示,碳酸司维拉默会使胃肠道不良事件增加多达60%(几率比:1.60,95% CI:1.31-1.97,共同(固定)效应模型):这项随机试验的荟萃分析表明,蔗糖铁氧氢氧化物和西维拉姆这两种药物都能同样有效地控制血清磷水平,而蔗糖铁氧氢氧化物在胃肠道不良事件方面的表现更好。在碳酸司维拉姆较难耐受的情况下,蔗糖铁氧氢氧化物是接受 KRT 的患者的重要选择。
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Efficacy and safety of sucroferric oxyhydroxide versus sevelamer carbonate: A systematic review and meta-analysis.

Introduction: Phosphate binders are commonly used in patients receiving kidney replacement therapy (KRT), aiming to reduce and maintain serum phosphorus. Chronic kidney disease-mineral and bone disorder has been linked to reduced lifespan and worsened quality of life. This study aims to examine the efficacy and safety of sucroferric oxyhydroxide versus sevelamer carbonate in patients receiving KRT.

Methods: The data sources examined were MEDLINE (PubMed), Scopus, and the Cochrane Central Register of Controlled Clinical Trials with a search deadline of October 2023. We examined randomized controlled trials that compared sucroferric oxyhydroxide versus sevelamer carbonate in the adult population receiving KRT. We performed a meta-analysis combining the data from trials, using R-studio.

Findings: Inclusion criteria were met by five randomized trials. There was no statistically significant difference in the reduction of serum phosphorus between the two groups (MD: -0.07 mmol/L, 95% CI-random effects: -0.15 to 0.02). In the same line, a non-statistically significant difference was observed in serum i-PTH reduction between the two drugs (MD = -1.53 mg/dL, 95% CI = (-4.45, 1.4), p = 0.26, random effects model). No statistically significant difference was observed in all adverse events between the two groups (odds ratio: 1.11, 95% CI: 0.65-1.88, random effects model). Further analysis of gastrointestinal adverse events revealed that sevelamer carbonate increases gastrointestinal adverse events by up to 60% (odds ratio: 1.60, 95% CI: 1.31-1.97, common (fixed) effect model).

Discussion: This meta-analysis of randomized trials showed that both drugs, sucroferric oxyhydroxide and sevelamer equally and effectively controlled serum phosphorus levels, whereas sucroferric oxyhydroxide revealed a better profile in terms of gastrointestinal adverse events. Sucroferric oxyhydroxide is a valuable option for patients receiving KRT when sevelamer carbonate is more difficult to tolerate.

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The effect of using a local skin cooling device on arteriovenous fistula cannulation pain and comfort level of patients on hemodialysis: A single-blind randomized controlled study. Prior central venous catheter placement and age are associated with earlier intervention after permanent hemodialysis access creation. Association between trace elements and cognitive function among hemodialysis patients in Turkey. Optimizing use of an electronic medical record system for quality improvement initiatives in hemodialysis: Review of a single center experience. Efficacy and safety of sucroferric oxyhydroxide versus sevelamer carbonate: A systematic review and meta-analysis.
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