Roxadustat reduces left ventricular mass index compared to rHuEPO in haemodialysis patients in a randomized controlled trial

IF 9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of Internal Medicine Pub Date : 2024-02-11 DOI:10.1111/joim.13770

Wei Tan, Xiang Wang, Yudong Sun, Xiaohui Wang, Jin He, Ling Zhong, Xianhong Jiang, Yan Sun, En Tian, Zhuoying Li, Liangping He, Ying Hao, Bin Tang, Wei Hua, Xiangyu Ma, Jurong Yang

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Abstract

Background

Left ventricular hypertrophy (LVH) is highly prevalent in haemodialysis (HD) patients and is associated with an increased risk of death. Roxadustat and recombinant human erythropoietin (rHuEPO, abbreviated as EPO) are the main treatment strategies for renal anaemia in HD patients, but it has not been clear whether there is a difference in their effect on LVH.

Methods

In this multi-centre, prospective, randomized trial of 12-month duration, study participants were randomized in a 1:1 ratio to the roxadustat group or the EPO group. The doses of both treatment regimens were adjusted so that the patients had a haemoglobin level of 10.0–12.0 g per dL. The primary study endpoint was the change from baseline to 12 months in the left ventricular mass index (LVMI, g/m²) measured by echocardiography.

Results

In total, 114 patients were enrolled. The mean age was 50 years, and the median dialysis duration was 33 months. Sixty-one patients were men, and 24 were diabetic. LVMI decreased from 116.18 ± 27.84 to 110.70 ± 25.74 g/m² in the roxadustat group. However, it increased from 109.35 ± 23.41 to 114.99 ± 28.46 g/m² in the EPO group, with a significant difference in the change in LVMI between the two groups [−5.48 (−11.60 to 0.65) vs. 5.65 (0.74 to 10.55), p < 0.05]. Changes in left ventricular mass, end-diastolic volume and 6-min walk test seemed superior in the roxadustat group. There were no significant differences in other cardiac geometry, biochemical parameters and major adverse cardiovascular events between the two groups.

Conclusions

Compared to EPO, roxadustat is more helpful in the regression of LVH in HD patients.

Abstract Image

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在一项随机对照试验中，与 rHuEPO 相比，罗沙司他可降低血液透析患者的左心室质量指数。

背景：左心室肥厚（LVH）在血液透析（HD）患者中非常普遍，并与死亡风险增加有关。罗沙司他和重组人促红细胞生成素（rHuEPO，简称 EPO）是治疗血液透析患者肾性贫血的主要方法，但这两种药物对 LVH 的影响是否存在差异尚不清楚：在这项为期 12 个月的多中心前瞻性随机试验中，研究参与者按 1:1 的比例随机分配到罗沙司他组或 EPO 组。两种治疗方案的剂量均经过调整，使患者的血红蛋白水平达到每分升 10.0-12.0 克。研究的主要终点是超声心动图测量的左心室质量指数（LVMI，克/平方米）从基线到12个月的变化：共有 114 名患者参与研究。平均年龄为 50 岁，中位透析时间为 33 个月。61名患者为男性，24名患者为糖尿病患者。罗沙司他组的 LVMI 从 116.18 ± 27.84 g/m2 降至 110.70 ± 25.74 g/m2。而 EPO 组的 LVMI 则从 109.35 ± 23.41 g/m2 增至 114.99 ± 28.46 g/m2，两组之间的 LVMI 变化差异显著[-5.48（-11.60 至 0.65）vs. 5.65（0.74 至 10.55），P 结论：罗沙度他与 EPO 相比，LVMI 变化更小：与 EPO 相比，罗沙度他汀更有助于缓解 HD 患者的 LVH。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Internal Medicine 医学-医学：内科

CiteScore

22.00

自引率

0.90%

发文量

176

审稿时长

4-8 weeks

期刊介绍： JIM – The Journal of Internal Medicine, in continuous publication since 1863, is an international, peer-reviewed scientific journal. It publishes original work in clinical science, spanning from bench to bedside, encompassing a wide range of internal medicine and its subspecialties. JIM showcases original articles, reviews, brief reports, and research letters in the field of internal medicine.