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1.中国航天科工集团七三一医院药学部,北京 100074
2.兰州大学循证医学中心,兰州 730013
3.北京医院药学部,北京 100010
Received:20 April 2022,
Revised:2022-09-05,
Published:30 October 2022
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郑丽,刘明,孙雪林.罗沙司他致不良反应的文献分析[J].中国药房,2022,33(20):2519-2523.
ZHENG Li,LIU Ming,SUN Xuelin.Literature analysis of adverse drug reactions induced by roxadustat[J].ZHONGGUO YAOFANG,2022,33(20):2519-2523.
郑丽,刘明,孙雪林.罗沙司他致不良反应的文献分析[J].中国药房,2022,33(20):2519-2523. DOI: 10.6039/j.issn.1001-0408.2022.20.17.
ZHENG Li,LIU Ming,SUN Xuelin.Literature analysis of adverse drug reactions induced by roxadustat[J].ZHONGGUO YAOFANG,2022,33(20):2519-2523. DOI: 10.6039/j.issn.1001-0408.2022.20.17.
目的
2
研究罗沙司他致不良反应(ADR)的临床表现和特点,为其临床合理应用提供参考。
方法
2
计算机检索PubMed、Web of Science、万方医学网、维普网及中国知网,收集罗沙司他致ADR的临床试验研究、病例报道(含病例系列研究和个案报道),采用描述性方法分析患者的基本信息、累及系统/器官及主要临床表现,并比较临床试验研究中罗沙司他组和促红细胞生成素(EPO)组患者的ADR发生率。
结果与结论
2
共纳入文献17篇,包括14篇临床试验研究和3篇病例报道。临床试验研究中,使用罗沙司他的患者共计4 033例,其中男性1 972例(48.9%)、女性2 061例(51.1%),年龄36~80岁;1项临床试验研究的患者类型为低风险骨髓增生异常综合征,其余均为肾性贫血;用药剂量为40~120 mg,大多为每周3次给药;罗沙司他所致ADR(1~2级)累及系统/器官以心脑血管系统、呼吸和胸部系统、消化系统、感染和侵染为主,所致严重不良反应(sADR)累及系统/器官以心脑血管系统、感染和侵染为主;罗沙司他组患者的ADR总发生率与EPO组比较,差异无统计学意义(
P
>0.05),但罗沙司他组患者sADR的发生率显著高于EPO组(
P
<0.05)。病例报道中,罗沙司他致ADR的临床表现为肺动脉高压、横纹肌溶解、疲劳。临床用药时需注意患者相关系统/器官的变化,如发现相关ADR,应及时干预。
OBJECTIVE
2
To study clinical manifestations and characteristics of adverse drug reactions (ADRs) induced by roxadustat, and to provide reference for rational use of it in clinic.
METHODS
2
Retrieved from PubMed, Web of Science, Wanfang Med, VIP and CNKI, clinical trials and case reports (including series studies and case reports) of ADRs induced by roxadustat were collected; descriptive method was used to analyze patients’ basic information, involved systems/organs and main clinical manifestations. The incidence of ADR was compared between roxadustat group and erythropoietin (EPO) group.
RESULTS &CONCLUSIONS
2
A total of 17 articles were included, including 14 clinical trials and 3 case reports. In the clinical trial studies, there were 4 033 patients using roxadustat, including 1 972 males (48.9%) and 2 061 females (51.1%), aged from 36 to 80 years. The type of patients in one clinical trial was low-risk myelodysplastic syndrome, and the others were renal anemia; they received relevant drugs with dosage of 40-120 mg, mostly three times a week. Roxadustat-induced ADR (1-2 grade) involved systems/organs mainly included cardiovascular system, respiratory and thoracic system, digestive system, infection and infestation. The major systems/organs involved in serious adverse drug reaction (sADR) were cardiovascular system, infection and infestation; there was no statistically significant difference in the incidence of ADR between roxadustat group and EPO group (
P
>0.05), but the incidence of sADR in roxadustat group was significantly higher than that in EPO group (
P
<0.05). In the case reports, pulmonary hypertension, rhabdomyolysis and fatigue were the clinical manifestations of ADRs induced by roxadustat. During clinical medication, attention should be paid to the changes in relevant systems/organs of patients. If ADR is found, timely intervention should be carried out.
ZHENG L , TIAN J H , LIU D P , et al . Efficacy and safety of roxadustat for anaemia in dialysis-dependent and non-dialysis-dependent chronic kidney disease patients:a systematic review and meta-analysis [J ] . Br J ClinPharmacol , 2022 , 88 ( 3 ): 919 - 932 .
LUO J C , JENSEN D E , MARONI B J , et al . Spectrum and burden of erythropoiesis-stimulating agent hypo-responsiveness among contemporary hemodialysis patients [J ] . Am J Kidney Dis , 2016 , 68 ( 5 ): 763 - 771 .
贺晓瑛 , 潘兴泉 , 李家国 , 等 . 治疗肾性贫血新药:roxadustat [J ] . 临床药物治疗杂志 , 2018 , 16 ( 8 ): 1 - 3,8 .
LI Y , SHI H , WANG W M , et al . Prevalence,awareness,and treatment of anemiain Chinese patients with nondialysis chronic kidney disease:first multicenter,cross-sectional study [J ] . Medicine(Baltimore) , 2016 , 95 ( 24 ): e3872 .
BESARAB A , PROVENZANO R , HERTEL J , et al . Randomized placebo-controlled dose-ranging and pharmacodynamics study of roxadustat(FG-4592)to treat anemia in nondialysis-dependent chronic kidney disease(NDD-CKD) patients [J ] . Nephrol Dial Transplant , 2015 , 30 ( 10 ): 1665 - 1673 .
PROVENZANO R , BESARAB A , WRIGHT S , et al . Roxadustat(FG-4592)versus epoetin alfa for anemia in patients receiving maintenance hemodialysis:a phase 2,randomized,6- to 19-week,open-label,active-comparator,dose-ranging,safety and exploratory efficacy study [J ] . Am J Kidney Dis , 2016 , 67 ( 6 ): 912 - 924 .
CHEN N , QIAN J Q , CHEN J H , et al . Phase 2 studies of oral hypoxia-inducible factor prolyl hydroxylase inhibitor FG-4592 for treatment of anemia in China [J ] . Nephrol Dial Transplant , 2017 , 32 ( 8 ): 1373 - 1386 .
AKIZAWA T , IWASAKI M , OTSUKA T , et al . Roxadustat treatment of chronic kidney disease-associated anemia in Japanese patients not on dialysis:a phase 2,randomized,double-blind,placebo-controlled trial [J ] . Adv Ther , 2019 , 36 ( 6 ): 1438 - 1454 .
CHEN N , HAO C M , LIU B C , et al . Roxadustat treatment for anemia in patients undergoing long-term dialysis [J ] . N Engl J Med , 2019 , 381 ( 11 ): 1011 - 1022 .
CHEN N , HAO C M , PENG X M , et al . Roxadustat for anemia in patients with kidney disease not receiving dialysis [J ] . N Engl J Med , 2019 , 381 ( 11 ): 1001 - 1010 .
AKIZAWA T , IWASAKI M , YAMAGUCHI Y , et al . Phase 3,randomized,double-blind,active-comparator(darbepoetin alfa)study of oral roxadustat in CKD patients with anemia on hemodialysis in Japan [J ] . J Am Soc Nephrol , 2020 , 31 ( 7 ): 1628 - 1639 .
HENRY D H , GLASPY J , HARRUP R , et al . Roxadustat for the treatment of anemia in patients with lower-risk myelodysplastic syndrome:open-label,dose-selection,lead-in stage of a phase 3 study [J ] . Am J Hematol , 2022 , 97 ( 2 ): 174 - 184 .
FISHBANE S , EL-SHAHAWY M A , PECOITS-FILHO R , et al . Roxadustat for treating anemiain patients with CKD not on dialysis:results from a randomized phase 3 study [J ] . J Am Soc Nephrol , 2021 , 32 ( 3 ): 737 - 755 .
CSIKY B , SCHÖMIG M , ESPOSITO C , et al . Roxadustat for the maintenance treatment of anemia in patients with end-stage kidney disease on stable dialysis:a European phase 3,randomized,open-label,active-controlled study(PYRENEES) [J ] . Adv Ther , 2021 , 38 ( 10 ): 5361 - 5380 .
SHUTOV E , SUŁOWICZ W , ESPOSITO C , et al . Roxadustat for the treatment of anemiain chronic kidney disease patients not on dialysis:a phase 3,randomized,double-blind,placebo-controlled study(ALPS) [J ] . Nephrol Dial Transplant , 2021 , 36 ( 9 ): 1629 - 1639 .
BARRATT J , ANDRIC B , TATARADZE A , et al . Erratum to:roxadustat for the treatment of anaemia in chronic kidney disease patients not on dialysis:a phase 3,rando-mised,open-label,active-controlled study(DOLOMITES) [J ] . Nephrol Dial Transplant , 2022 , 37 ( 4 ): 805 .
HOU Y P , MAO X Y , WANG C , et al . Roxadustat treatment for anemiain peritoneal dialysis patients:a rando-mized controlled trial [J ] . Taiwan Yi Zhi , 2022 , 121 ( 2 ): 529 - 538 .
PROVENZANO R , SHUTOV E , EREMEEVA L , et al . Roxadustat for anemia in patients with end-stage renal disease incident to dialysis [J ] . Nephrol Dial Transplant , 2021 , 36 ( 9 ): 1717 - 1730 .
CYGULSKA K , WEJNER-MIK P , PLEWKA M , et al . Roxadustat:another drug that causes pulmonary hypertension:report of first human case [J ] . Pol Arch Intern Med , 2019 , 129 ( 5 ): 344 - 345 .
LI J , MA K F , WANG L P , et al . Efficacy and safety of roxadustat in the treatment of renal allograft anemia patients:a case series [J ] . Ann Palliat Med , 2021 , 10 ( 11 ): 11859 - 11867 .
YANG Q , WANG X . A case report of rhabdomyolysis caused by the use of roxadustat in the treatment caused by renal anaemia [J ] . Int J Clin Pract , 2021 , 75 ( 6 ): e14011 .
皋文君 , 刘砚燕 , 袁长蓉 . 国际肿瘤化疗药物不良反应评价系统:通用不良反应术语标准4. 0版 [J ] . 肿瘤 , 2012 , 32 ( 2 ): 142 - 144 .
LI Z L , TU Y , LIU B C . Treatment of renal anemia with roxadustat:advantages and achievement [J ] . Kidney Dis(Basel) , 2020 , 6 ( 2 ): 65 - 73 .
CORESH J , SELVIN E , STEVENS L A , et al . Prevalence of chronic kidney disease in the United States [J ] . JAMA , 2007 , 298 ( 17 ): 2038 - 2047 .
QIE S H , JIAO N , DUAN K F , et al . The efficacy and safety of roxadustat treatment for anemiain patients with kidney disease:a meta-analysis and systematic review [J ] . Int Urol Nephrol , 2021 , 53 ( 5 ): 985 - 997 .
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