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

Table 20:

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

Population: Anemia in dialysis-dependent chronic kidney disease

Intervention: Desidustat

Comparator: Epoetin alfa

Outcome

Time frame

Study results and measurements Absolute effect estimates Certainty of the evidence Plain language summary
Epoetin Alpha Desidustat
All-cause mortality up to 26 weeks

Odds ratio: 0.56

(CI 95% 0.16–1.95)

Based on data from 392 participants in one study

36

per 1000

20

per 1000

Very low

Due to very serious risk of bias, due to very serious imprecision1

We are uncertain whether desidustat (any dose) decreases all-cause mortality up to 26 weeks in comparison with ESAs.

Difference: 16 fewer per 1000

(CI 95% 30 fewer–32 more)

Need for iron supplementation No studies were found that viewed the need for iron supplementation.
Need for ESA No studies were found that viewed the need for ESA.
Incidences of MACE and MACE plus No studies were found that viewed incidences of MACE and MACE plus.
Treatment emergent adverse events up to 26 weeks Odds ratio: 1.06 (CI 95% 0.72–1.58) Based on data from 392 participants in one study

464

per 1000

478

per 1000

Very low

Due to very serious risk of bias, due to very serious imprecision2

We are uncertain whether desidustat (any dose) increases treatment emergent adverse events up to 26 weeks.
Difference: 15 more per 1000 (CI 95% 80 fewer–114 more)
Patients requiring blood transfusion No studies were found that viewed patients requiring blood transfusion.
Change in hemoglobin levels from baseline up to 16–24 weeks

Measured by:

Scale: High better

Based on data from 373 participants in one study

Mean Mean

Very low

Due to very serious risk of bias, due to serious imprecision3

Desidustat may have little or no difference compared with ESAs on changes in hemoglobin levels from baseline up to 16–24 weeks.

Difference: MD 0.07 lower

(CI 95% 0.23 lower–0.37 lower)

Fatigue No studies were found that viewed fatigue.
QoL assessed by SF-36 up to 24 weeks Measured by: SF-36 Scale: High better Based on data from 346 participants in one study Mean Mean

Very low

Due to very serious risk of bias, due to serious imprecision4

We are uncertain whether desidustat worsens QoL assessed by SF-36 up to 24 weeks.
Difference: MD 49.73 higher (CI 95% 144.53 higher–45.07 lower)

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