Comparison 1.
ESA versus ESA or placebo/no treatment
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
|---|---|---|---|---|
| 1 Blood transfusion | 19 | Odds Ratio (M‐H, Random, 95% CI) | Subtotals only | |
| 1.1 Epoetin alfa versus placebo | 3 | 196 | Odds Ratio (M‐H, Random, 95% CI) | 0.07 [0.01, 0.84] |
| 1.2 Epoetin beta versus placebo | 2 | 230 | Odds Ratio (M‐H, Random, 95% CI) | 0.07 [0.03, 0.21] |
| 1.3 Darbepoetin alfa versus placebo | 1 | 4038 | Odds Ratio (M‐H, Random, 95% CI) | 0.53 [0.46, 0.63] |
| 1.4 Epoetin alfa versus control | 1 | 157 | Odds Ratio (M‐H, Random, 95% CI) | 3.10 [0.16, 58.97] |
| 1.5 Epoetin beta versus no control | 1 | 40 | Odds Ratio (M‐H, Random, 95% CI) | 0.35 [0.06, 2.18] |
| 1.6 Epoetin alfa versus darbepoetin alfa | 3 | 1191 | Odds Ratio (M‐H, Random, 95% CI) | 2.31 [1.34, 3.97] |
| 1.7 Epoetin alfa versus biosimilar ESA | 3 | 1823 | Odds Ratio (M‐H, Random, 95% CI) | 0.72 [0.42, 1.22] |
| 1.8 Epoetin beta versus methoxy polyethylene glycol‐epoetin beta | 1 | 181 | Odds Ratio (M‐H, Random, 95% CI) | 0.83 [0.17, 4.15] |
| 1.9 Darbepoetin alfa versus methoxy polyethylene glycol‐epoetin beta | 4 | 1191 | Odds Ratio (M‐H, Random, 95% CI) | 0.94 [0.45, 1.95] |
| 2 Fatigue | 3 | Odds Ratio (IV, Random, 95% CI) | Subtotals only | |
| 2.1 Epoetin alfa versus darbepoetin alfa | 2 | 551 | Odds Ratio (IV, Random, 95% CI) | 0.94 [0.57, 1.55] |
| 2.2 Epoetin alfa v biosimilar ESA | 1 | 179 | Odds Ratio (IV, Random, 95% CI) | 0.18 [0.01, 3.91] |
| 3 Breathlessness | 3 | Odds Ratio (IV, Random, 95% CI) | Subtotals only | |
| 3.1 Epoetin alfa versus darbepoetin alfa | 1 | 504 | Odds Ratio (IV, Random, 95% CI) | 0.71 [0.46, 1.10] |
| 3.2 Epoetin alfa versus biosimilar ESA | 2 | 794 | Odds Ratio (IV, Random, 95% CI) | 0.68 [0.37, 1.25] |
| 4 All‐cause mortality | 31 | Odds Ratio (M‐H, Random, 95% CI) | Subtotals only | |
| 4.1 Epoetin alfa versus placebo | 2 | 235 | Odds Ratio (M‐H, Random, 95% CI) | 0.99 [0.14, 6.86] |
| 4.2 Epoetin beta versus placebo | 3 | 311 | Odds Ratio (M‐H, Random, 95% CI) | 0.61 [0.17, 2.15] |
| 4.3 Darbepoetin alfa versus placebo | 1 | 4038 | Odds Ratio (M‐H, Random, 95% CI) | 1.06 [0.91, 1.24] |
| 4.4 Epoetin alfa versus control | 1 | 157 | Odds Ratio (M‐H, Random, 95% CI) | 1.06 [0.39, 2.87] |
| 4.5 Epoetin beta versus control | 3 | 468 | Odds Ratio (M‐H, Random, 95% CI) | 0.69 [0.36, 1.33] |
| 4.6 Epoetin alfa versus darbepoetin alfa | 6 | 1205 | Odds Ratio (M‐H, Random, 95% CI) | 1.12 [0.59, 2.14] |
| 4.7 Epoetin alfa versus biosimilar ESA | 7 | 2220 | Odds Ratio (M‐H, Random, 95% CI) | 1.04 [0.53, 2.01] |
| 4.8 Epoetin beta versus darbepoetin alfa | 1 | 217 | Odds Ratio (M‐H, Random, 95% CI) | 0.89 [0.38, 2.09] |
| 4.9 Epoetin beta versus methoxy polyethylene glycol‐epoetin beta | 2 | 462 | Odds Ratio (M‐H, Random, 95% CI) | 0.81 [0.12, 5.35] |
| 4.10 Epoetin beta versus biosimilar ESA | 1 | 290 | Odds Ratio (M‐H, Random, 95% CI) | 0.34 [0.04, 2.82] |
| 4.11 Darbepoetin alfa versus methoxy polyethylene glycol‐epoetin beta | 4 | 1429 | Odds Ratio (M‐H, Random, 95% CI) | 0.90 [0.59, 1.40] |
| 5 Cardiovascular mortality | 14 | Odds Ratio (M‐H, Random, 95% CI) | Subtotals only | |
| 5.1 Epoetin beta versus placebo | 2 | 260 | Odds Ratio (M‐H, Random, 95% CI) | 0.45 [0.06, 3.75] |
| 5.2 Darbepoetin alfa versus placebo | 1 | 4038 | Odds Ratio (M‐H, Random, 95% CI) | 1.05 [0.87, 1.26] |
| 5.3 Epoetin beta versus no treatment | 3 | 430 | Odds Ratio (M‐H, Random, 95% CI) | 0.28 [0.08, 1.03] |
| 5.4 Epoetin alfa versus darbepoetin alfa | 2 | 487 | Odds Ratio (M‐H, Random, 95% CI) | 2.15 [0.31, 14.91] |
| 5.5 Epoetin alfa versus biosimilar ESA | 2 | 657 | Odds Ratio (M‐H, Random, 95% CI) | 0.53 [0.20, 1.35] |
| 5.6 Epoetin beta versus biosimilar ESA | 1 | 290 | Odds Ratio (M‐H, Random, 95% CI) | 0.34 [0.04, 2.82] |
| 5.7 Darbepoetin alfa versus methoxy polyethylene glycol‐epoetin beta | 3 | 938 | Odds Ratio (M‐H, Random, 95% CI) | 0.69 [0.32, 1.48] |
| 6 Myocardial infarction | 9 | Odds Ratio (M‐H, Random, 95% CI) | Subtotals only | |
| 6.1 Epoetin alfa versus placebo | 1 | 14 | Odds Ratio (M‐H, Random, 95% CI) | 3.46 [0.12, 100.51] |
| 6.2 Darbepoetin alfa versus placebo | 1 | 4038 | Odds Ratio (M‐H, Random, 95% CI) | 0.97 [0.75, 1.25] |
| 6.3 Epoetin alfa versus no treatment | 1 | 157 | Odds Ratio (M‐H, Random, 95% CI) | 1.01 [0.04, 25.26] |
| 6.4 Epoetin alfa versus darbepoetin alfa | 2 | 825 | Odds Ratio (M‐H, Random, 95% CI) | 0.87 [0.20, 3.81] |
| 6.5 Epoetin alfa versus biosimilar | 2 | 641 | Odds Ratio (M‐H, Random, 95% CI) | 1.23 [0.49, 3.12] |
| 6.6 Darbepoetin alfa versus methoxy polyethylene glycol‐epoetin beta | 2 | 628 | Odds Ratio (M‐H, Random, 95% CI) | 0.47 [0.06, 3.65] |
| 7 Stroke | 12 | Odds Ratio (M‐H, Random, 95% CI) | Subtotals only | |
| 7.1 Epoetin beta versus placebo | 1 | 106 | Odds Ratio (M‐H, Random, 95% CI) | 0.33 [0.01, 8.21] |
| 7.2 Darbepoetin alfa versus placebo | 1 | 4038 | Odds Ratio (M‐H, Random, 95% CI) | 1.97 [1.40, 2.76] |
| 7.3 Epoetin alfa versus control | 1 | 157 | Odds Ratio (M‐H, Random, 95% CI) | 0.99 [0.10, 9.82] |
| 7.4 Epoetin beta versus control | 1 | 33 | Odds Ratio (M‐H, Random, 95% CI) | 0.20 [0.01, 5.39] |
| 7.5 Epoetin alfa versus darbepoetin alfa | 3 | 996 | Odds Ratio (M‐H, Random, 95% CI) | 1.44 [0.37, 5.54] |
| 7.6 Epoetin alfa versus biosimilar ESA | 3 | 718 | Odds Ratio (M‐H, Random, 95% CI) | 0.92 [0.39, 2.15] |
| 7.7 Darbepoetin alfa versus methoxy polyethylene glycol‐epoetin beta | 2 | 628 | Odds Ratio (M‐H, Random, 95% CI) | 1.33 [0.17, 10.49] |
| 8 Hypertension | 24 | Odds Ratio (M‐H, Random, 95% CI) | Subtotals only | |
| 8.1 Epoetin alfa versus placebo | 2 | 251 | Odds Ratio (M‐H, Random, 95% CI) | 4.10 [2.16, 7.76] |
| 8.2 Epoetin beta versus placebo | 2 | 230 | Odds Ratio (M‐H, Random, 95% CI) | 2.95 [1.19, 7.26] |
| 8.3 Darbepoetin alfa versus placebo | 1 | 4038 | Odds Ratio (M‐H, Random, 95% CI) | 1.14 [0.99, 1.32] |
| 8.4 Epoetin alfa versus control | 1 | 157 | Odds Ratio (M‐H, Random, 95% CI) | 5.31 [0.30, 95.20] |
| 8.5 Epoetin beta versus no treatment | 2 | 382 | Odds Ratio (M‐H, Random, 95% CI) | 2.99 [1.34, 6.69] |
| 8.6 Epoetin alfa versus darbepoetin alfa | 5 | 1568 | Odds Ratio (M‐H, Random, 95% CI) | 0.94 [0.62, 1.43] |
| 8.7 Epoetin alfa versus biosimilar ESA | 4 | 1464 | Odds Ratio (M‐H, Random, 95% CI) | 1.77 [1.02, 3.09] |
| 8.8 Epoetin beta versus darbepoetin alfa | 1 | 162 | Odds Ratio (M‐H, Random, 95% CI) | 1.18 [0.38, 3.69] |
| 8.9 Epoetin beta versus methoxy polyethylene glycol‐epoetin beta | 1 | 181 | Odds Ratio (M‐H, Random, 95% CI) | 1.38 [0.62, 3.09] |
| 8.10 Darbepoetin alfa versus methoxy polyethylene glycol‐epoetin beta | 5 | 1497 | Odds Ratio (M‐H, Random, 95% CI) | 0.94 [0.62, 1.42] |
| 9 Vascular access thrombosis | 11 | Odds Ratio (M‐H, Random, 95% CI) | Subtotals only | |
| 9.1 Epoetin alfa versus placebo | 1 | 118 | Odds Ratio (M‐H, Random, 95% CI) | 6.40 [0.80, 51.50] |
| 9.2 Epoetin beta versus placebo | 1 | 99 | Odds Ratio (M‐H, Random, 95% CI) | 1.09 [0.28, 4.34] |
| 9.3 Darbepoetin alfa versus placebo | 1 | 4038 | Odds Ratio (M‐H, Random, 95% CI) | 1.34 [0.30, 6.01] |
| 9.4 Epoetin beta versus control | 1 | 362 | Odds Ratio (M‐H, Random, 95% CI) | 1.40 [0.72, 2.73] |
| 9.5 Epoetin alfa versus darbepoetin alfa | 3 | 1084 | Odds Ratio (M‐H, Random, 95% CI) | 1.15 [0.73, 1.82] |
| 9.6 Epoetin alfa versus biosimilar | 2 | 823 | Odds Ratio (M‐H, Random, 95% CI) | 1.74 [0.30, 10.00] |
| 9.7 Epoetin beta versus methoxy polyethylene glycol‐epoetin beta | 1 | 181 | Odds Ratio (M‐H, Random, 95% CI) | 1.74 [0.49, 6.24] |
| 9.8 Darbepoetin alfa versus methoxy polyethylene glycol‐epoetin beta | 1 | 489 | Odds Ratio (M‐H, Random, 95% CI) | 0.76 [0.39, 1.47] |
| 10 End‐stage kidney disease | 7 | Odds Ratio (M‐H, Random, 95% CI) | Subtotals only | |
| 10.1 Darbepoetin alfa versus placebo | 1 | 4038 | Odds Ratio (M‐H, Random, 95% CI) | 1.04 [0.88, 1.23] |
| 10.2 Epoetin alfa versus control | 1 | 17 | Odds Ratio (M‐H, Random, 95% CI) | 0.27 [0.03, 2.12] |
| 10.3 Epoetin beta versus control | 2 | 106 | Odds Ratio (M‐H, Random, 95% CI) | 0.40 [0.08, 1.93] |
| 10.4 Epoetin alfa versus darbepoetin alfa | 2 | 492 | Odds Ratio (M‐H, Random, 95% CI) | 2.17 [0.37, 12.74] |
| 10.5 Darbepoetin alfa versus methoxy polyethylene glycol‐epoetin beta | 1 | 305 | Odds Ratio (M‐H, Random, 95% CI) | 1.83 [0.66, 5.09] |
| 11 Major cardiovascular events | 5 | Odds Ratio (M‐H, Random, 95% CI) | Subtotals only | |
| 11.1 Darbepoetin alfa versus placebo | 1 | 4038 | Odds Ratio (M‐H, Random, 95% CI) | 1.08 [0.95, 1.24] |
| 11.2 Epoetin alfa versus control | 1 | 157 | Odds Ratio (M‐H, Random, 95% CI) | 2.40 [0.29, 20.11] |
| 11.3 Epoetin beta versus control | 1 | 33 | Odds Ratio (M‐H, Random, 95% CI) | 0.61 [0.07, 4.98] |
| 11.4 Epoetin alfa versus darbepoetin alfa | 1 | 321 | Odds Ratio (M‐H, Random, 95% CI) | 0.20 [0.01, 4.17] |
| 11.5 Epoetin alfa versus biosimilar epoetin | 1 | 462 | Odds Ratio (M‐H, Random, 95% CI) | 0.49 [0.17, 1.47] |