■Roxadustat,一种治疗肾性贫血的口服药物,是一种缺氧诱导因子脯氨酸酰羟化酶抑制剂,用于调节铁代谢和促进红细胞生成。探讨罗沙司他对腹膜透析(PD)患者促红细胞生成素低反应性的疗效和安全性。
■单中心,回顾性研究,将81例PD患者(促红细胞生成素低反应性)分为罗沙司他组(n=61)和红细胞生成刺激剂(ESA)组(n=20)。血红蛋白(Hb),总胆固醇,完整的甲状旁腺激素(iPTH),脑钠肽(BNP),收集心功能相关指标及超敏C反应蛋白(hs-CRP)。此外,还记录了不良事件.随访期为16周。
■两组表现出相似的基线人口统计学和临床特征。在基线,罗沙司他组的平均Hb水平为89.8±18.9g/L,而ESAs组的平均Hb水平为95.2±16.0g/L。到第16周,罗沙司他组的Hb水平增加到118±19.8g/L(p<0.05),ESA组的Hb水平增加到101±19.3g/L(p>0.05)。罗沙司他改善贫血的疗效不受hs-CRP和iPTH基线水平的影响。在不使用他汀类药物的情况下,罗沙司坦组的胆固醇降低。在罗沙司他组观察到左心室射血分数增加和BNP稳定。
■对于红细胞生成素低反应性的PD患者,罗沙司他能明显改善肾性贫血。罗沙司他改善肾性贫血的功效不受hs-CRP0和iPTH基线水平的影响。
OBJECTIVE: Roxadustat, an oral medication for treating renal anemia, is a hypoxia-inducible factor prolyl hydroxylase inhibitor used for regulating iron metabolism and promoting erythropoiesis. To investigate the efficacy and safety of roxadustat in patients undergoing peritoneal dialysis (PD) with erythropoietin hyporesponsiveness.
METHODS: Single-center, retrospective study, 81 PD patients (with erythropoietin hyporesponsiveness) were divided into the roxadustat group (n = 61) and erythropoiesis-stimulating agents (ESAs) group (n = 20). Hemoglobin (Hb), total cholesterol, intact parathyroid hormone (iPTH), brain natriuretic peptide (BNP), related indicators of cardiac function and high-sensitivity C-reactive protein (hs-CRP) were collected. Additionally, adverse events were also recorded. The follow-up period was 16 weeks.
RESULTS: The two groups exhibited similar baseline demographic and clinical characteristics. At baseline, the roxadustat group had a mean Hb level of 89.8 ± 18.9 g/L, while the ESAs group had a mean Hb level of 95.2 ± 16.0 g/L. By week 16, the Hb levels had increased to 118 ± 19.8 g/L (p < 0.05) in the roxadustat group and 101 ± 19.3 g/L (p > 0.05) in the ESAs group. The efficacy of roxadustat in improving anemia was not influenced by baseline levels of hs-CRP and iPTH. Cholesterol was decreased in the roxadustat group without statin use. An increase in left ventricular ejection fraction and stabilization of BNP were observed in the roxadustat group.
CONCLUSIONS: For PD patients with erythropoietin hyporesponsiveness, roxadustat can significantly improve renal anemia. The efficacy of roxadustat in improving renal anemia was not affected by baseline levels of hs-CRP0 and iPTH.