Summary

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• This summary is based on the review of nine systematic review(s)/meta-analysis(es). ^[1-11]
• Daprodustat significantly increased hemoglobin levels in chronic kidney disease (CKD) patients compared to placebo (MD = 1.86, 95% CI (0.00, 0.11) [1.20; 2.52]) and demonstrated no significant difference in hemoglobin changes compared to recombinant human erythropoietin (RHEPO) in both dialysis-dependent (DD) and non-dialysis-dependent (NDD) CKD patients.
• Daprodustat improved iron metabolism markers such as ferritin and total iron binding capacity (TIBC), showing a reduction in serum ferritin (MD = -180.84, 95% CI [-264.47; -97.20]) and an increase in TIBC (MD = 11.03, 95% CI [3.15; 18.92]).
• Comparative effectiveness showed that daprodustat's ability to elevate hemoglobin levels was similar to that of rhEPO and other hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs), with roxadustat demonstrating slightly higher efficacy in hemoglobin correction among HIF-PHIs.
• Daprodustat did not show an increased risk of adverse events (AES) or serious adverse events (SAES) compared to erythropoiesis-stimulating agents (ESA) or placebo in both dialysis-dependent and non-dialysis-dependent chronic kidney disease (CKD) patients. The incidence of thromboembolic and retinal events was comparable between daprodustat and ESA.
• Gastrointestinal disorders, such as diarrhea and vomiting, were more common with daprodustat compared to ESA. Additionally, there was an increased risk of thrombosis and headache associated with hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs), including daprodustat.
• The studies included both dialysis-dependent (DD) and non-dialysis-dependent (NDD) chronic kidney disease (CKD) patients, with daprodustat showing no significant difference in hemoglobin changes between these two groups. In DD-CKD patients, daprodustat improved iron metabolism more effectively than recombinant human erythropoietin (RHEPO). Adverse events were more common in NDD-CKD patients treated with daprodustat compared to rhEPO, but trial sequential analysis (TSA) corrected this finding. Additionally, daprodustat showed lower vascular-access complications compared to erythropoiesis-stimulating agents (ESA).