Meta-analysis Of The Efficacy And Safety Of Tenapanor In The Treatment Of Hyperphosphatemia In Maintenance Dialysis Patients

Background and Objective:Hyperphosphatemia is a common chronic abnormal bone metabolism and mineralization in patients with end-stage renal disease,and its correlation with cardiovascular disease has been proven.The control of serum phosphorus in maintenance dialysis patients is not optimistic globally.Therefore,the research of various phosphorus reducing drugs is the hot spot at present,and the results of the research on the phosphorus reducing effect and safety of Tenapanor are not the same.To this end,we conducted a meta analysis to evaluate the efficacy and safety of tenapanor in the management of hyperphosphatemia in patients on maintenance dialysis.Methods:CNKI,Wanfang Data,VIP,Chinese Bio Medical Literature Database(CBM),the Cochrane library,Pub Med,Web Of Science,EMBASE were searched from the time when the databases were established to July 31,2022.Reports on randomized controlled trials on treating hyperphosphatemia with tenapanor were collected.Data were extracted and assessed independently by two reviewers and the methodological quality of the included RCTs was assessed by Jadad Modified Scoring Scale.Meta-analysis was performed using Rev Man 5.3 software.Results:A total of 6 RCTs with 1067 patients were included.In terms of efficacy,metaanalysis of 4 studies(n=580)showed that tenapanor alone or in combination with phosphorus binder could reduce serum phosphorus concentration in patients with hyperphosphatemia(MD=-1.40,95%CI:-2.22 to-0.58,P=0.0008)compared with placebo or placebo combined with phosphorus binders.Two other studies in the ITT analysis set showed that before and after treatment,the least-square mean difference of serum phosphorus change between the control group and experimental group was-0.7mg/dl(P=0.002)and-0.65 mg/dl(P < 0.001),respectively,also indicating that tenapanor could effectively reduce serum phosphorus.In terms of safety,there was no significant difference in drug-related AEs between the experimental group and the control group(P=0.13).The most common drug-related AEs was diarrhea.Conclusion:Tenapanor can effectively reduce serum phosphorus levels in maintenance dialysis patients with hyperphosphatemia.The main drug-related adverse event is diarrhea,which is mostly tolerable.