Summary of findings for the main comparison. CERA versus other ESA for the anaemia of end‐stage kidney disease in dialysis patients.
| CERA versus other ESA for the anaemia of end‐stage kidney disease in dialysis patients | ||||||
| Patient or population: patients with the anaemia of end‐stage kidney disease undergoing dialysis Settings: tertiary centres Intervention: CERA versus other ESA | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | CERAversus other ESA | |||||
| Final Hb g/dL: CERA every 2 weeks versus rHuEPO | Mean final Hb g/dL: CERA every 2 weeks versus rHuEPO in the intervention groups was 0.08 higher (0.04 lower to 0.21 higher) | 1126 (4) | ⊕⊕⊕⊕ high | |||
| Final Hb g/dL: CERA every 4 week versus rHuEPO | Mean final Hb g/dL: CERA every 4 weeks versus rHuEPO in the intervention groups was 0.03 lower (0.17 lower to 0.12 higher) | 672 (2) | ⊕⊕⊕⊕ high | |||
| Final Hb g/dL: CERA every 2 week versus darbepoetin | Mean final Hb g/dL: CERA every 2 weeks versus darbepoetin in the intervention groups was 0.3 higher (0.05 to 0.55 higher) | 249 (1) | ⊕⊕⊕⊝ moderate¹ | |||
| All‐cause mortality: CERA every 2 weeks versus rHuEPO | Study population | RR 1.03 (0.67 to 1.57) | 1341 (4) | ⊕⊕⊕⊝ moderate² | ||
| 62 per 1000 | 64 per 1000 (41 to 97) | |||||
| Moderate | ||||||
| 61 per 1000 | 63 per 1000 (41 to 96) | |||||
| Transfusions: CERA every 2 weeks versus rHuEPO | Study population | RR 0.92 (0.64 to 1.32) | 1341 (4) | ⊕⊕⊕⊝ moderate² | ||
| 90 per 1000 | 83 per 1000 (58 to 119) | |||||
| Moderate | ||||||
| 88 per 1000 | 81 per 1000 (56 to 116) | |||||
| Numbers of adverse events due to hypertension: CERA every 2 weeks versus rHuEPO | Study population | RR 0.93 (0.69 to 1.26) | 1341 (4) | ⊕⊕⊕⊕ high | ||
| 151 per 1000 | 140 per 1000 (104 to 190) | |||||
| Moderate | ||||||
| 149 per 1000 | 139 per 1000 (103 to 188) | |||||
| Numbers of adverse events due to access thrombosis: CERA every 2 weeks versus rHuEPO | Study population | RR 0.96 (0.56 to 1.65) | 1341 (4) | ⊕⊕⊕⊝ moderate³ | ||
| 92 per 1000 | 88 per 1000 (52 to 152) | |||||
| Moderate | ||||||
| 85 per 1000 | 82 per 1000 (48 to 140) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate Very low quality: We are very uncertain about the estimate | ||||||
¹ One study, 249 participants ² Small numbers of events ³ Heterogeneity among studies