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Cochrane Database of Systematic Reviews

Short‐acting erythropoiesis‐stimulating agents for anaemia in predialysis patients

Information

DOI:
https://doi.org/10.1002/14651858.CD011690.pub2Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 09 January 2017see what's new
Type:
  1. Intervention
Stage:
  1. Review
Cochrane Editorial Group:
  1. Cochrane Kidney and Transplant Group

Copyright:
  1. Copyright © 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Deirdre Hahn

    Correspondence to: Department of Nephrology, The Children's Hospital at Westmead, Westmead, Australia

    [email protected]

  • Christopher I Esezobor

    Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria

  • Noha Elserafy

    Department of Nephrology, The Children's Hospital at Westmead, Westmead, Australia

  • Angela C Webster

    Sydney School of Public Health, The University of Sydney, Sydney, Australia

    Centre for Transplant and Renal Research, Westmead Millennium Institute, The University of Sydney at Westmead, Westmead, Australia

    Cochrane Kidney and Transplant, Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia

  • Elisabeth M Hodson

    Sydney School of Public Health, The University of Sydney, Sydney, Australia

    Cochrane Kidney and Transplant, Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia

Contributions of authors

  1. Draft the protocol: DH, EH

  2. Study selection: DH, EH, NE

  3. Extract data from studies: DH, EH, CE, NE

  4. Enter data into RevMan: DH, CE, EH

  5. Carry out the analysis: DH, EH, CE

  6. Interpret the analysis: DH, EH

  7. Draft the final review: DH, EH

  8. Disagreement resolution: AW

  9. Update the review: DH, EH

Declarations of interest

  • Deirdre Hahn: none known

  • Elisabeth M Hodson: none known

  • Angela C Webster: none known

  • Noha Elserafy: none known

  • Christopher Esezobor: none known

Acknowledgements

We acknowledge the assistance of the Cochrane Kidney and Transplant editorial office for their assistance with this review. We would also like to thank the referees for their feedback and advice during the preparation of this review.

Version history

Published

Title

Stage

Authors

Version

2017 Jan 09

Short‐acting erythropoiesis‐stimulating agents for anaemia in predialysis patients

Review

Deirdre Hahn, Christopher I Esezobor, Noha Elserafy, Angela C Webster, Elisabeth M Hodson

https://doi.org/10.1002/14651858.CD011690.pub2

2015 May 25

Short‐acting erythropoiesis‐stimulating agents for anaemia in predialysis patients

Protocol

Deirdre Hahn, Christopher I Esezobor, Noha Elserafy, Angela C Webster, Elisabeth M Hodson

https://doi.org/10.1002/14651858.CD011690

Differences between protocol and review

Removal of the comparison of short‐acting ESAs in evaluating the benefits and harms of different Hb or HCT targets in CKD patients receiving ESA treatment for anaemia as this is included in another systematic review (Strippoli 2006).

Keywords

MeSH

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Study flow diagram.
Figures and Tables -
Figure 1

Study flow diagram.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figures and Tables -
Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figures and Tables -
Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Epoetin alpha every 2 weeks versus weekly, Outcome 1 Change in haemoglobin level.
Figures and Tables -
Analysis 1.1

Comparison 1 Epoetin alpha every 2 weeks versus weekly, Outcome 1 Change in haemoglobin level.

Comparison 1 Epoetin alpha every 2 weeks versus weekly, Outcome 2 Number reaching target haemoglobin.
Figures and Tables -
Analysis 1.2

Comparison 1 Epoetin alpha every 2 weeks versus weekly, Outcome 2 Number reaching target haemoglobin.

Comparison 1 Epoetin alpha every 2 weeks versus weekly, Outcome 3 Number of deaths.
Figures and Tables -
Analysis 1.3

Comparison 1 Epoetin alpha every 2 weeks versus weekly, Outcome 3 Number of deaths.

Comparison 1 Epoetin alpha every 2 weeks versus weekly, Outcome 4 Adverse events.
Figures and Tables -
Analysis 1.4

Comparison 1 Epoetin alpha every 2 weeks versus weekly, Outcome 4 Adverse events.

Comparison 2 Epoetin alpha every 4 weeks versus every 2 weeks, Outcome 1 Change in haemoglobin level.
Figures and Tables -
Analysis 2.1

Comparison 2 Epoetin alpha every 4 weeks versus every 2 weeks, Outcome 1 Change in haemoglobin level.

Comparison 2 Epoetin alpha every 4 weeks versus every 2 weeks, Outcome 2 Number reaching target haemoglobin.
Figures and Tables -
Analysis 2.2

Comparison 2 Epoetin alpha every 4 weeks versus every 2 weeks, Outcome 2 Number reaching target haemoglobin.

Comparison 2 Epoetin alpha every 4 weeks versus every 2 weeks, Outcome 3 Number of deaths.
Figures and Tables -
Analysis 2.3

Comparison 2 Epoetin alpha every 4 weeks versus every 2 weeks, Outcome 3 Number of deaths.

Comparison 2 Epoetin alpha every 4 weeks versus every 2 weeks, Outcome 4 Adverse events.
Figures and Tables -
Analysis 2.4

Comparison 2 Epoetin alpha every 4 weeks versus every 2 weeks, Outcome 4 Adverse events.

Comparison 3 Epoetin alpha different doses given three times weekly, Outcome 1 Final haemoglobin.
Figures and Tables -
Analysis 3.1

Comparison 3 Epoetin alpha different doses given three times weekly, Outcome 1 Final haemoglobin.

Comparison 3 Epoetin alpha different doses given three times weekly, Outcome 2 Mean arterial BP.
Figures and Tables -
Analysis 3.2

Comparison 3 Epoetin alpha different doses given three times weekly, Outcome 2 Mean arterial BP.

Comparison 3 Epoetin alpha different doses given three times weekly, Outcome 3 Final creatinine levels.
Figures and Tables -
Analysis 3.3

Comparison 3 Epoetin alpha different doses given three times weekly, Outcome 3 Final creatinine levels.

Comparison 4 Epoetin alpha different doses given every four weeks, Outcome 1 Final haemoglobin.
Figures and Tables -
Analysis 4.1

Comparison 4 Epoetin alpha different doses given every four weeks, Outcome 1 Final haemoglobin.

Comparison 4 Epoetin alpha different doses given every four weeks, Outcome 2 Number reaching target haemoglobin.
Figures and Tables -
Analysis 4.2

Comparison 4 Epoetin alpha different doses given every four weeks, Outcome 2 Number reaching target haemoglobin.

Comparison 4 Epoetin alpha different doses given every four weeks, Outcome 3 Number of deaths.
Figures and Tables -
Analysis 4.3

Comparison 4 Epoetin alpha different doses given every four weeks, Outcome 3 Number of deaths.

Comparison 4 Epoetin alpha different doses given every four weeks, Outcome 4 Adverse events.
Figures and Tables -
Analysis 4.4

Comparison 4 Epoetin alpha different doses given every four weeks, Outcome 4 Adverse events.

Comparison 5 Epoetin alpha IV versus subcutaneous administration, Outcome 1 Final haemoglobin.
Figures and Tables -
Analysis 5.1

Comparison 5 Epoetin alpha IV versus subcutaneous administration, Outcome 1 Final haemoglobin.

Comparison 6 Epoetin theta versus epoetin beta, Outcome 1 Final Hb.
Figures and Tables -
Analysis 6.1

Comparison 6 Epoetin theta versus epoetin beta, Outcome 1 Final Hb.

Comparison 6 Epoetin theta versus epoetin beta, Outcome 2 Mean weekly epoetin dose.
Figures and Tables -
Analysis 6.2

Comparison 6 Epoetin theta versus epoetin beta, Outcome 2 Mean weekly epoetin dose.

Comparison 6 Epoetin theta versus epoetin beta, Outcome 3 Deaths.
Figures and Tables -
Analysis 6.3

Comparison 6 Epoetin theta versus epoetin beta, Outcome 3 Deaths.

Comparison 6 Epoetin theta versus epoetin beta, Outcome 4 Adverse events.
Figures and Tables -
Analysis 6.4

Comparison 6 Epoetin theta versus epoetin beta, Outcome 4 Adverse events.

Summary of findings for the main comparison. Epoetin alpha every 2 weeks versus to weekly for anaemia in CKD patients not receiving dialysis

Epoetin alpha every 2 weeks versus to weekly for anaemia in CKD patients not receiving dialysis

Patient or population: anaemia in predialysis patients
Intervention: epoetin alpha every 2 weeks
Comparison: weekly

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with weekly

Risk with Epoetin alpha every 2 weeks

Change in Hb level

The mean change in Hb level was 0 g/dL

The mean change in Hb level in the intervention group was 0.19 g/dL lower (0.32 g/dL lower to 0.06 g/dL lower)

798 (4)

⊕⊕⊝⊝
LOW 1 2

downgraded for study limitations and indirectness

Number reaching target Hb

Study population

RR 0.96
(0.93 to 0.99)

798 (4)

⊕⊕⊝⊝
LOW 1 2

downgraded for study limitations and indirectness

960 per 1000

922 per 1000
(893 to 951)

Moderate

947 per 1000

910 per 1000
(881 to 938)

Number of deaths

Study population

RR 0.89
(0.38 to 2.07)

838 (4)

⊕⊕⊝⊝
LOW 1 3

downgraded for study limitations and imprecision

28 per 1000

24 per 1000
(10 to 57)

Moderate

22 per 1000

20 per 1000
(9 to 46)

Adverse events: RBC transfusions

Study population

RR 1.56
(0.71 to 3.45)

580 (3)

⊕⊕⊝⊝
LOW 3 4

downgraded for imprecision and study limitations

33 per 1000

52 per 1000
(23 to 114)

Moderate

37 per 1000

58 per 1000
(26 to 128)

Adverse events: hypertension

Study population

RR 0.85
(0.55 to 1.32)

838 (4)

⊕⊕⊕⊝
MODERATE 1

downgraded for study limitations

100 per 1000

85 per 1000
(55 to 132)

Moderate

95 per 1000

81 per 1000
(52 to 126)

Adverse events: thrombovascular events

Study population

RR 1.41
(0.67 to 3.00)

838 (4)

⊕⊕⊝⊝
LOW 1 3

downgraded for study limitations and imprecision

28 per 1000

39 per 1000
(18 to 83)

Moderate

27 per 1000

38 per 1000
(18 to 80)

*The risk in the intervention group (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; OR: Odds ratio; Hb: haemoglobin; RBC: red blood cells

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1 allocation concealment unclear in 3 of 4 studies

2 surrogate outcome

3 few studies with low numbers and wide confidence

4 allocation concealment unclear in 2 of 3 studies

Figures and Tables -
Summary of findings for the main comparison. Epoetin alpha every 2 weeks versus to weekly for anaemia in CKD patients not receiving dialysis
Summary of findings 2. Epoetin alfa every four weeks versus with every two weeks in CKD patients not receiving dialysis

Epoetin alfa every four weeks versus with every two weeks in CKD patients not receiving dialysis

Patient or population: anaemia in predialysis patients
Intervention: epoetin alpha every 4 weeks
Comparison: every 2 weeks

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with every 2 weeks

Risk with Epoetin alpha every 4 weeks

Change in Hb level

The mean change in Hb level was 0

The mean change in Hb level in the intervention group was 0.15g/dL lower (0.41 g/dL lower to 0.1g/dL more)

671 (3)

⊕⊝⊝⊝
VERY LOW 1 2 3

downgraded for study limitations, heterogeneity and indirectness

Number reaching target Hb

Study population

RR 0.95
(0.84 to 1.07)

687 (3)

⊕⊝⊝⊝
VERY LOW 1 2 3

downgraded for study limitations, heterogeneity and indirectness

916 per 1000

870 per 1000
(769 to 980)

Moderate

895 per 1000

850 per 1000
(752 to 957)

Number of deaths

Study population

RR 0.95
(0.33 to 2.75)

724 (3)

⊕⊕⊝⊝
LOW 1 4

downgraded for study limitations, imprecision

22 per 1000

21 per 1000
(7 to 62)

Moderate

26 per 1000

25 per 1000
(9 to 72)

Adverse events: RBC transfusions

Study population

RR 1.26
(0.53 to 2.98)

470 (2)

⊕⊕⊝⊝
LOW 1 4

downgraded for study limitations, imprecision

38 per 1000

48 per 1000
(20 to 114)

Moderate

35 per 1000

44 per 1000
(18 to 103)

Adverse events: hypertension

Study population

RR 1.02
(0.62 to 1.69)

724 (3)

⊕⊕⊕⊝
MODERATE 1

downgraded for study limitations

70 per 1000

72 per 1000
(44 to 119)

Moderate

62 per 1000

63 per 1000
(38 to 104)

Adverse events: arteriovenous complications

Study population

RR 1.02
(0.39 to 2.68)

724 (3)

⊕⊕⊝⊝
LOW 1 4

downgraded for study limitations, imprecision

26 per 1000

26 per 1000
(10 to 68)

Moderate

23 per 1000

24 per 1000
(9 to 62)

*The risk in the intervention group (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; OR: Odds ratio; Hb: haemoglobin; RBC: red blood cells

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1 two of the three studies had unclear allocation concealment

2 surrogate outcome

3 unexplained heterogeneity

4 small numbers with wide confidence intervals

Figures and Tables -
Summary of findings 2. Epoetin alfa every four weeks versus with every two weeks in CKD patients not receiving dialysis
Summary of findings 3. Epoetin theta versus epoetin beta in CKD patients not receiving dialysis

Epoetin theta versus epoetin beta in CKD patients not receiving dialysis

Patient or population: anaemia in predialysis patients
Intervention: epoetin theta
Comparison: epoetin beta

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with epoetin beta

Risk with Epoetin theta

Final Hb

The mean final Hb was 0 g/dL

The mean final Hb in the intervention group was 0.02 g/dL lower (0.25 g/dL lower to 0.21 g/dL higher)

288 (1)

⊕⊕⊕⊝
MODERATE 1

downgraded for indirectness ‐ surrogate outcomes

Mean weekly epoetin dose

The mean weekly epoetin dose was 0 units/week

The mean weekly epoetin dose in the intervention group was 0.4 units per week higher (5.68 units per week lower 6.48 units/week higher)

288 (1)

⊕⊕⊝⊝
LOW 1 2

downgraded for indirectness ‐ surrogate outcomes and imprecision

Deaths

Study population

RR 2.46
(0.29 to 20.77)

288 (1)

⊕⊕⊝⊝
LOW 2

downgraded for imprecision

11 per 1000

26 per 1000
(3 to 219)

Moderate

11 per 1000

26 per 1000
(3 to 218)

Adverse events: hypertension

Study population

RR 0.35
(0.11 to 1.08)

288 (1)

⊕⊕⊕⊝
MODERATE 2

downgraded for imprecision

74 per 1000

26 per 1000
(8 to 80)

Moderate

74 per 1000

26 per 1000
(8 to 80)

Adverse events: RBC transfusions

Study population

RR 1.48
(0.06 to 36.10)

288 (1)

⊕⊕⊝⊝
LOW 2

downgraded for imprecision

0 per 1000

0 per 1000
(0 to 0)

Adverse events: discontinuation of therapy

Study population

RR 1.77
(0.68 to 4.63)

288 (1)

⊕⊕⊝⊝
LOW 2

downgraded for imprecision

53 per 1000

93 per 1000
(36 to 244)

Moderate

53 per 1000

93 per 1000
(36 to 244)

*The risk in the intervention group (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; OR: Odds ratio; RBC: red blood cells

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1 Surrogate outcome, not a patient‐centred outcome

2 Small numbers, wide confidence intervals

Figures and Tables -
Summary of findings 3. Epoetin theta versus epoetin beta in CKD patients not receiving dialysis
Comparison 1. Epoetin alpha every 2 weeks versus weekly

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in haemoglobin level Show forest plot

4

785

Mean Difference (IV, Random, 95% CI)

‐0.20 [‐0.33, ‐0.07]

2 Number reaching target haemoglobin Show forest plot

4

798

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.93, 0.99]

3 Number of deaths Show forest plot

4

838

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.38, 2.07]

4 Adverse events Show forest plot

4

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 RBC transfusions

3

580

Risk Ratio (M‐H, Random, 95% CI)

1.56 [0.71, 3.45]

4.2 Hypertension

4

838

Risk Ratio (M‐H, Random, 95% CI)

0.85 [0.55, 1.32]

4.3 Thrombovascular events

4

838

Risk Ratio (M‐H, Random, 95% CI)

1.41 [0.67, 3.00]

4.4 Adverse events leading to discontinuation of therapy

1

258

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.20, 4.79]

Figures and Tables -
Comparison 1. Epoetin alpha every 2 weeks versus weekly
Comparison 2. Epoetin alpha every 4 weeks versus every 2 weeks

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in haemoglobin level Show forest plot

3

671

Mean Difference (IV, Random, 95% CI)

‐0.16 [‐0.43, 0.10]

2 Number reaching target haemoglobin Show forest plot

3

687

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.84, 1.07]

3 Number of deaths Show forest plot

3

724

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.33, 2.75]

4 Adverse events Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 RBC transfusions

2

470

Risk Ratio (M‐H, Random, 95% CI)

1.26 [0.53, 2.98]

4.2 Hypertension

3

724

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.62, 1.69]

4.3 Arteriovenous complications

3

724

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.39, 2.68]

Figures and Tables -
Comparison 2. Epoetin alpha every 4 weeks versus every 2 weeks
Comparison 3. Epoetin alpha different doses given three times weekly

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Final haemoglobin Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 100 U/kg versus 50 U/kg

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 150 U/kg versus 50 U/kg

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 Mean arterial BP Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 100 IU/kg/wk versus 50 IU/kg/wk

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 150 IU/kg/wk versus 50 IU/kg/wk

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 Final creatinine levels Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3.1 100 IU/kg/wk versus 50 IU/kg/wk

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 150 IU/kg/wk versus 50 IU/kg/wk

1

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 3. Epoetin alpha different doses given three times weekly
Comparison 4. Epoetin alpha different doses given every four weeks

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Final haemoglobin Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2 Number reaching target haemoglobin Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3 Number of deaths Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4.1 Hypertension

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Thrombovascular events

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 RBC transfusions

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 4. Epoetin alpha different doses given every four weeks
Comparison 5. Epoetin alpha IV versus subcutaneous administration

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Final haemoglobin Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figures and Tables -
Comparison 5. Epoetin alpha IV versus subcutaneous administration
Comparison 6. Epoetin theta versus epoetin beta

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Final Hb Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2 Mean weekly epoetin dose Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3 Deaths Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Adverse events Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4.1 Hypertension

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 RBC transfusions

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Discontinuation of therapy

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 6. Epoetin theta versus epoetin beta