Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis
Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis
复制标题
DOI：
10.1111/j.1523-1755.2004.00450.x
复制
发表时间：
2004-03-01
影响因子：
19.6
通讯作者：
Zagari, M
中科院分区：
文献类型：
--
作者：
Jones, M;Ibels, L;Zagari, M
背景资料。大量随机对照试验表明，重组人促红细胞生成素(rHuEPO，Epoetin alfa)显著提高了慢性肾功能衰竭贫血患者的血红蛋白水平，减少了输血需求，并改善了患者的生活质量。然而，这些积累的数据尚未得到系统的检查。这项荟萃分析的目的是通过收集和分析已发表的证据来量化促红细胞生成素对临床疗效、生活质量、住院和输血的影响。16项已发表的研究符合所有纳入标准，并进行了数据提取。然后，使用随机效应荟萃分析将与血红蛋白和/或红细胞压积水平、生活质量测量、住院次数和时间以及输血次数相关的数据汇集在一起进行研究。计算预先选择的变量的简单组合估计，并使用元回归进行调整估计。合并研究组的基线血红蛋白水平(11g/dL)。生活质量的所有指标都有实质性的改善(10%到70%)。此外，接受促红细胞生成素治疗的患者在住院率、住院时间、输血率和输血单位数方面显著减少。这一荟萃分析有力地表明，对于慢性肾功能衰竭患者，促红细胞生成素α疗法在显著减少住院和输血的同时，提供了重要的临床和生活质量益处。
Background. Numerous randomized, controlled trials have demonstrated that recombinant human erythropoietin (rHuEPO, epoetin alfa) significantly raises hemoglobin levels, reduces transfusion requirements, and improves quality of life in anemic patients with chronic renal failure. However, this accumulation of data has yet to be systematically examined. The objectives of this meta-analysis were to quantify the effects of epoetin alfa on clinical efficacy, quality of life, hospitalizations, and transfusions by collecting and analyzing the published body of evidence.Methods. Sixteen published studies fulfilled all inclusion criteria and were subjected to data extraction. Data specifically related to hemoglobin and/or hematocrit levels, quality-of-life measurements, number and length of hospitalizations, and number of blood transfusions were then pooled across studies using a random effects meta-analysis. Simple combined estimates of the preselected variables were calculated, and adjusted estimates were made using meta-regression.Results. Baseline hemoglobin levels ( 11 g/dL) for the pooled study group. Substantial improvements (10% to 70%) were observed for all measures of quality of life. In addition, patients who received epoetin alfa had substantial reductions in hospitalization rate, hospital length of stay, transfusion rate, and number of units transfused.Conclusion. This meta-analysis strongly suggests that epoetin alfa therapy for patients with chronic renal failure provides important clinical and quality-of-life benefits while substantially reducing hospitalizations and transfusions.