低氧诱导因子 酸酶抑制剂 在脏疾病中
Jeffrey T Ha1,2, Swapnil Hiremath3, Min Jun2
1Department of Renal Medicine, Wollongong Hospital, Wollongong, NSW, Australia.
NEJM evidence
|August 26, 2024
概括
低氧诱导因子酸酶抑制剂的长期心血管安全性与慢性病患者的血液缺乏症的红色素形成刺激剂相比相当. 这一系统性审查没有发现主要心血管不良事件的显著差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性病 (CKD) 中的贫血通常用口服缺氧诱导因子 (HIF) 酸酶抑制剂治疗.
- 这些新型口服药物的长期安全性需要彻底评估.
研究的目的:
- 系统地审查和元分析HIF基氧酶抑制剂的长期安全性,与已知的治疗方法相比.
- 评估主要不良心血管事件 (MACE) 和其他安全结果的发生率.
主要方法:
- 对相关的随机试验进行了对MEDLINE,Embase和Cochrane数据库的全面搜索.
- 包含的试验是那些随访时间至少为48周的试验,比较HIF prolyl氧酶抑制剂与红色素形成刺激剂 (ESA) 或安慰剂.
- 随机效应模型被用来汇集MACE (所有原因死亡,心肌梗塞,中风) 的数据.
主要成果:
- 分析了25项试验,共有26,478名参与者 (透析依赖性和非透析依赖性CKD).
- 在依赖透析 (RR 0.99,95% CI 0.92-1.08) 或非依赖透析的CKD (RR 1.08,95% CI 0.95-1.22) 中,在HIF普罗利氧化酶抑制剂和ESA之间没有发现MACE的显著差异.
- 在非透析依赖的CKD中,HIF基酶抑制剂显示了与安慰剂相似的MACE风险 (RR 1.10,95% CI 0.96-1.27). 在非透析依赖性CKD的安慰剂对照试验中,一些不良事件在使用HIF抑制剂时更频繁.
结论:
- 在依赖透析和不依赖透析的慢性病患者中,HIF 基酶抑制剂的长期心血管安全性与 ESA 相同.
- 与现有疗法相比,HIF prolyl氧酶抑制剂的安全性概况在主要心血管结果方面令人放心.
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