钠-氢交换机同工酶 3 抑制剂 Tenapanor 作为慢性肾病高磷血症创新疗法的有效性和安全性概况：临床研究系统回顾

IF 2 4区医学 Q2 UROLOGY & NEPHROLOGY

Nefrologia Pub Date : 2024-11-01 DOI:10.1016/j.nefro.2024.06.007

William Suciangto , Haerani Rasyid , Anastasya Angelica Vicente , Winny Suciangto

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引用次数: 0

摘要

背景慢性肾脏病（CKD）是全球主要的健康问题。高磷血症是慢性肾脏病的常见病，也是发病率和死亡率增加的原因之一，因为它会导致甲状旁腺功能亢进、高成纤维细胞生长因子 23 (FGF23) 和低钙血症。现有的高磷血症疗法仍有其局限性，包括金属超载风险、心血管钙化和全身不良反应（AEs）。方法以 "tenapanor"、"慢性肾脏病 "和 "高磷血症 "为关键词，通过 "pubmed "和 "science direct "进行文献检索。采用 2020 版 PRISMA 算法筛选文献。根据人群、干预、比较和结果（PICO）标准对文献进行筛选：需要透析的 CKD 患者为研究对象，替那帕诺或其与透析或磷酸盐结合剂的组合为干预措施，安慰剂或其他磷酸盐结合剂（不含替那帕诺）为对比措施，血清磷酸盐、安全性以及与高磷酸盐血症治疗相关的其他多效应为研究结果。然后对纳入的研究进行了偏倚风险评估和定性审查。结果替那帕诺能降低血清磷酸盐，一般呈剂量依赖性。特纳帕诺还能抑制 FGF23 和甲状旁腺激素，这可能是由于血清磷酸盐降低所致。常见的不良反应是一过性轻度至中度腹泻，与剂量有关。由于特纳帕诺不含钙、不含金属且吸收率低，因此总体上耐受性良好，全身AEs较低。

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Effectivity and safety profile of tenapanor, a sodium-hydrogen exchanger isoform 3 inhibitor, as an innovative treatment for hyperphosphatemia in chronic kidney disease: A systematic review of clinical studies

Background

Chronic kidney disease (CKD) is a major global health problem. Hyperphosphatemia is frequent in CKD and a reason for increased morbidity and mortality as it generates hyperparathyroidism, high fibroblast growth factor 23 (FGF23), and hypocalcemia. Available hyperphosphatemia therapies still have limitations, including risk of metal overload, cardiovascular calcification, and systemic adverse effects (AEs). Tenapanor is a new hyperphosphatemia treatment in CKD with sodium-hydrogen exchanger isoform 3 (NHE3) inhibition mechanism and low systemic AEs.

Objectives

Discovering the effectivity and safety of tenapanor as hyperphosphatemia management in CKD.

Method

Literature searching is performed by using “pubmed” and “science direct” with “tenapanor”, “chronic kidney disease”, and “hyperphosphatemia” as keywords. The literatures were selected using PRISMA algorithm version 2020. Literature was screened based on Population, Intervention, Comparison, and Outcome (PICO) criteria which are: CKD patients requiring dialysis as population, tenapanor or its combination with dialysis or phosphate binders as intervention, placebo or other phosphate binders without tenapanor as comparison, and serum phosphate, safety profile, and other pleiotropic benefits related to hyperphosphatemia management as the outcome. The included studies then assessed for risk of bias and qualitatively reviewed.

Outcome

Tenapanor was able to reduce serum phosphate, generally in a dose-dependent manner. Tenapanor also suppressed FGF23 and parathyroid hormone, probably due to decreased serum phosphate. The frequent AEs were transient mild-to-moderate diarrhea in a dose-dependent manner. Tenapanor was generally well-tolerated with low systemic AEs due to its non-calcium, metal-free, and low-absorbed properties.

Conclusion

Tenapanor is an effective and safe option for hyperphosphatemia management in CKD.

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来源期刊

Nefrologia 医学-泌尿学与肾脏学

CiteScore

3.40

自引率

7.70%

发文量

148

审稿时长

47 days

期刊介绍： Nefrología is the official publication of the Spanish Society of Nephrology. The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants. It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages.