在贫症中以算法管理剂量和药剂师管理的红素激活剂剂量:系统性审查

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Francisca Johanna van den Oever^1,2, Marijke J E Dekker³, Erwin C Vasbinder⁴

¹Department of Pharmacy, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands c.vandenoever@franciscus.nl.

European journal of hospital pharmacy : science and practice

|February 19, 2025

概括

药剂师管理的质素刺激剂 (ESA) 用于脏贫血的剂量可以改善血红蛋白水平并减少ESA剂量. 然而,低质量的证据和高度的偏见阻止了关于有效性的最终结论.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
药理学药理学是指药理学的学科.
基于证据的医学基于证据的医学

背景情况:

贫症是慢性病患者的常见并发症.
红色素形成刺激剂 (ESA) 对于治疗贫血至关重要.
优化ESA剂量对于患者的治疗结果和资源管理至关重要.

研究的目的:

系统地审查和总结以算法管理和药剂师管理的ESA在贫血中的剂量.
评估这些剂量策略对关键结果参数的影响.
评估有关ESA治疗脏贫血的现有证据的质量.

主要方法:

按照PRISMA指南进行系统审查.
包括随访时间≥6个月的观察性和干预性研究和对照组.
从创建到2024年8月搜索相关数据库;使用ROBINS-I和RoB1工具评估偏差风险.

主要成果:

包括17篇涉及4313名患者的文章;证据质量低至中等,偏差风险高.
由于显著的异质性,元分析是不可行的.
药剂师管理的ESA剂量显示出改善血红蛋白目标范围 (3.5%低至32.0%高) 和减少ESA剂量 (5.45%至49.97%) 的潜力.

结论:

低质量的证据表明,药剂师管理的ESA剂量可能有利于脏贫血患者.
偏见的高风险和实质性的异质性阻止了最终的结论.
需要进一步进行高质量的研究,以确定药剂师管理的ESA剂量的有效性.

关键词:

贫血贫血是一种疾病.慢性功能衰竭慢性功能衰竭透析是通过透析进行的.经济学,药品制造业功能衰竭,慢性功能衰竭系统审查是系统的审查.

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