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. 2025 Feb 25;35(2):129–167. doi: 10.25259/ijn_389_23

Table 2:

Evidence profile for desidustat as an alternative to ESA for anemia in NDD-CKD patients

Population: Anemia in non-dialysis-dependent chronic kidney disease

Intervention: Desidustat (any dose)

Comparator: Darbepoetin alpha

Outcome

Time frame

Study results and measurements Absolute effect estimates

Certainty of tde Evidence (Quality of evidence)

Plain language summary
Darbepoetin alpha Desidustat (any dose)
Any adverse events up to 26 weeks in ESA-naïve patients

Odds ratio: 0.91

(CI 95% 0.66–1.26)

Based on data from 588 participants in one study

503

per 1000

479

per 1000

Low

Due to serious risk of bias, due to serious imprecision1

We are uncertain whether desidustat (any dose) decreases adverse events up to 26 weeks in ESA-naïve patients.
Difference: 24 fewer per 1000 (CI 95% 103 fewer–301 fewer)
All-cause mortality up to 26 weeks in ESA-naïve patients

Odds ratio: 1.0

(CI 95% 0.32–3.14)

Based on data from 588 participants in one study

20

per 1000

20

per 1000

Low

Due to serious risk of bias, due to serious imprecision2

We are uncertain whether compared to conventional ESA, desidustat has no difference in all-cause mortality up to 26 weeks in ESA-naïve patients.

Difference: 0 fewer per 1000

(CI 95% 14 fewer–40 more)

Incidences of MACE and MACE plus No studies were found that viewed incidences of MACE and MACE plus.
Progression to end-stage kidney disease No studies were found that viewed progression to end-stage kidney disease.
Need for iron supplement No studies were found that viewed the need for iron supplementation.
Patient requiring blood transfusion No studies were found that viewed a patient requiring blood transfusion.
Change in hemoglobin levels from baseline up to 24 weeks in ESA-naïve patients

Measured by:

Scale: High better

Based on data from 529 participants in one study

Mean

Mean

Low

Due to serious risk of bias, due to serious imprecision3

Desidustat (any dose) probably has little or no difference on change in hemoglobin levels from baseline compared to ESA up to 24 weeks in ESA-naïve patients.

Difference: MD 0.09 lower

(CI 95% 0.15 lower–0.33 lower)

QoL (SF 36 score) at 24 weeks in ESA-naïve patients

Measured by:

Scale: High better

Based on data from 480 participants in one study

Mean Mean

Low

Due to serious risk of bias, due to serious imprecision4

Desidustat may have little or no difference on QoL (SF 36 score) at 24 weeks in ESA-naïve patients.

Difference: MD 0.00 lower

(CI 95% 98.20 lower–98.20 lower)

Fatigue No studies were found that viewed fatigue.
Need for ESA up to 24 weeks in ESA-naïve patients Based on data from 588 participants in one study

Low

Due to serious risk of bias, due to serious imprecision5

There were too few ESA-naïve patients who experienced the need for ESA up to 24 weeks to determine whether desidustat (any dose) made a difference.

Risk of Bias: serious. Missing intention-to-treat analysis, inadequate/lack of blinding of participants and personnel, resulting in potential for performance bias; Imprecision: serious. Wide confidence intervals, only data from one study, inadequate optimal information size (OIS); The 95% CI of the included study overlaps line of no effect (i.e., CI includes 1.0) rate. Risk of Bias: serious. Inadequate/lack of blinding of participants and personnel, resulting in potential for performance bias, missing intention-to-treat analysis; Imprecision: serious. Wide confidence intervals, only data from one study, inadequate optimal information size (OIS); Publication bias: not serious. Study is commercially funded. Risk of Bias: serious. Inadequate/lack of blinding of participants and personnel, resulting in potential for performance bias, missing intention-to-treat analysis; Imprecision: serious. Only data from one study, inadequate optimal information size (OIS); Publication bias: not serious. Study is commercially funded. Risk of Bias: serious. Inadequate/lack of blinding of participants and personnel, resulting in potential for performance bias, missing intention-to-treat analysis; Imprecision: serious. Only data from one study, inadequate optimal information size (OIS); Publication bias: not serious. Study is commercially funded. Risk of Bias: serious. Inadequate/lack of blinding of participants and personnel, resulting in potential for performance bias, missing intention-to-treat analysis; Imprecision: serious. Low number of patients, only data from one study, inadequate optimal information size (OIS); Publication bias: not serious. Study is commercially funded. ESA: Eythropoiesis-stimulating agents, NDD: Nondialysis dependent, CKD: Chronic kidney disease, MACE: Major adverse cardiovascular events, CI: Confidence interval, SF 36: Short Form 36, MD: Mean difference, QoL: Quality of life.