Efficacy of daprodustat for patients on dialysis with anemia: systematic review and network meta-analysis

TL;DR

This study finds that daprodustat improves blood hemoglobin and iron levels more effectively than other treatments in dialysis patients with anemia.

Contribution

The study provides a network meta-analysis showing daprodustat's superior efficacy over conventional anemia treatments in dialysis patients.

Findings

Daprodustat 25-30 mg showed the greatest increase in serum hemoglobin compared to other treatments.

Daprodustat reduced serum ferritin and increased total iron binding capacity in a dose-dependent manner.

The results suggest daprodustat is more effective than recombinant human erythropoietin and iron supplements.

Abstract

Chronic kidney disease (CKD) is commonly complicated by anemia. Treating dialysis-dependent patients with anemia, including daprodustat and other inhibitors of prolyl hydroxylase of hypoxia-inducible factor, recombinant human erythropoietin (rhEPO), and iron supplements. We conducted this study to test our postulation; daprodustat is superior to rhEPO and other conventional treatments respecting efficacy and safety parameters. We made systematic search through PubMed, Web of Science, Scopus, and Cochrane. Seven unique trials were eventually included for systematic review; six of them with a sample size of 759 patients entered our network meta-analysis (NMA). Daprodustat 25-30 mg was associated with the greatest change in serum hemoglobin (MD=1.86, 95%CI= [1.20; 2.52]), ferritin (MD= -180.84, 95%CI= [-264.47; -97.20]), and total iron binding capacity (TIBC) (MD=11.03, 95%CI= [3.15; 18.92]) from baseline values. Dialysis-dependent patients with anemia had a significant increment in serum Hemoglobin and TIBC and a reduction in serum ferritin, in a dose-dependent manner, when administered daprodustat.

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