Effect of Roxadustat on cardiovascular-related events
Sixteen trials that reported cardiovascular-related events after the use of Roxadustat were eventually included in the study. Nine of these trials were conducted with NDD patients and six with DD patients. Meta-analysis indicated that oral Roxadustat did not cause serious adverse effects or cardiovascular-related events in anemic patients with CKD, irrespective of whether the patients received dialysis (RR = 1.181; CI [0.925 to 1.507]; P = 1.334, I2 = 0.0%) or did not receive dialysis (RR = 1.036; CI [0.916 to 1.171]; P = 0.576, I2 = 0.0%) (Figure 3A).Moreover, subgroup analysis also suggested that oral Roxadustat did not cause a significant difference in the risk of cardiovascular events in anemic patients with CKD when compared with placebo (RR = 1.049; CI [0.918 to 1.200]; P = 0.479, I2 = 10.8%) or ESA (RR = 1.099; CI [0.907 to 1.331]; P = 0.336, I2 = 0.0%) (Figure 3B). Additionally, there was a low degree of heterogeneity between the included trials on cardiovascular adverse events with Roxadustat compared to placebo. Removal of Besbrab’s study from the sensitivity analysis reduced the heterogeneity to 0.0% (I2 = 0.0%, P = 0.493).