Efficacy and safety of lanthanum carbonate in patients on maintenance hemodialysis:a Meta-analysis / 天津医药

ABSTRACT

Objective To assess the treatment efficacy and safety of lanthanum carbonate (LC) in patients on maintenance hemodialysis. Methods MEDLINE (1996—2014), Embase (1974—2014.12), Pubmed (1996—2014.12), Cochrane library, Chinese Wanfang database (1996—2014.12) and CNKI (1979—2014.12) were searched. Lanthanum carbonate and hemodialysis were used as Chinese and English search terms respectively, and the articles met the inclusion and exclusion criteria were used as supplements. Quality assessment and data mining were conducted by two independent investigators who performed Meta-analysis using RevMan5.2. Results Nine trials with 2 674 participants were included in this study. The Meta-analysis showed that there were similar blood levels of calcium [WMD=-0.24,95%CI(-0.61)-0.14, P=0.21], phosphorus [WMD=0.14,95%CI(-0.02)-0.30,P=0.08] and phosphate control rates (RR=0.91,95%CI0.70-1.17, P=0.44) between control group and lanthanum carbonate group. There were lower incidence rates of hypercalcemia (RR=0.17, 95%CI0.06-0.47, P=0.000 7) and blood levels of calcium-phosphorus product [WMD=-2.17,95%CI(-3.99)-(-0.35), P=0.02], and higher levels of parathyroid hormone (iPTH, WMD=105.69, 95%CI70.38-141.00, P<0.000 01) and bone-specific alkaline phosphatase (BAP, WMD=6.47, 95%CI0.43-12.50, P=0.04) in these two groups. There were no significant differences in incidence rates of gastrointestinal adverse events between two groups. Conclusion Lanthanum carbonate should be used as preferred choice of phosphate binders to control serum phosphorus in patients on maintenance hemodialysis.