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Abstract: TH-PO695

Roxadustat vs. Erythropoiesis-Stimulating Agents and the Effect on Lipid Profile in Dialysis-Dependent Patients With Anemia of Renal Disease: A Meta-Analysis of Phase 3 Randomized Controlled Trials

Session Information

  • Anemia and Iron Metabolism
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Mekraksakit, Poemlarp, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Leelaviwat, Natnicha, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas, United States
  • Dejhansathit, Siroj, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas, United States
  • Del Rio-Pertuz, Gaspar, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas, United States
  • Cheungpasitporn, Wisit, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Benjanuwattra, Juthipong, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas, United States
  • Duangkham, Samapon, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas, United States
Background

Multiple recent studies have shown that roxadustat was non-inferior to erythropoiesis-stimulating agents (ESAs) in treatment of anemia of renal disease. However, the effects of roxadustat on lipid levels have not been well explored.

Methods

We searched the databases of MEDLINE and Embase from inception to April 2022. We included phase 3 randomized controlled trials (RCTs) that evaluated the efficacy of roxadustat versus ESAs in dialysis-dependent (DD) patients. Data were combined using the random-effects model and the inverse-variance method.

Results

Seven RCTs involving 5,391 DD patients from July 2019 to April 2022 were included. When compared to ESAs, roxadustat significantly decreased total cholesterol (mean difference [MD] -23.22 mg/dL; 95% -27.88, -18.56; I2=72%), LDL (MD -15.04 mg/dL; 95% CI -17.16, -12.91; I2=55%), and triglyceride levels (MD -9.61 mg/dL; 95% CI -15.29, -3.92; I2=0%). Although HDL cholesterol levels decreased significantly (MD -3.48 mg/dL; 95% CI -4.37, -2.59; I2=31%), an improvement in the LDL:HDL ratio was observed (MD -0.21; 95% CI -0.27, -0.15; I2=0%). Roxadustat was non-inferior to ESAs in hemoglobin response (MD 0.21 g/dL; 95% CI 0.10, 0.33; I2=87%) and decrease of hepcidin level (MD -17.56 ng/mL; 95% CI -31.97, -3.15; I2=81%). There is no difference of patients having a first blood transfusion between the two groups (pooled HR 0.86; 95% CI 0.63, 1.16; I2=55%).

Conclusion

Our meta-analysis indicated that roxadustat significantly decreased total cholesterol, LDL, LDL:HDL ratio, HDL, and triglyceride levels compared to ESAs. Further studies are needed to clarify this association.