AimTo evaluate the efficacy and safety of colestilan as a phosphorus binder in dialysis patients, we performed a meta-analysis of randomized controlled trials. MethodsWe retrieved studies that compared colestilan with placebo in the treatment of dialysis patients from Medline, EMBASE, the Cochrane Library and conference proceedings. ResultsFour studies were included. The treatment durations ranged from 2 to 12 weeks, median 7.5 weeks. Compared with placebo group, colestilan significantly decreased serum phosphorus (WMD, -0.22mmol/L; 95% CI, -0.33 to -0.12, P<0.0001), calcium phosphorus product (WMD, -0.70mmol(2)/L-2; 95% CI, -1.06 to -0.35, P=0.0001), intact PTH (WMD, -5.37pmol/L; 95% CI, -8.38 to -2.36, P=0.0005) and LDL cholesterol (WMD, -0.78mmol/L; 95% CI, -0.85 to -0.71, P<0.00001). There was no significant difference in serum calcium between the two groups. Colestilan therapy increased gastrointestinal complaints significantly (OR=4.07, 95% CI: 3.06-6.53, P<0.00001). Sensitivity analysis was performed by excluding studies with Jadad score of three or 3g/day colestilan, the results did not change. ConclusionsShort-term administration of colestilan is effective for the treatment of hyperphosphataemia in dialysis patients. Long-term effectiveness and safety needs to be evaluated. Summary at a Glance Colestilan, a non-absorbable non-metallic anion exchange resin, is used traditionally as a lipid-lowering drug; however, recent interest has been with its potential use as a phosphate binder. This systematic review evaluates the limited but important literature relating to trials assessing the benefits and adverse effects of colestilan for lowering phosphate levels in patients on dialysis.
[1]Fudan Univ, Huashan Hosp, Div Nephrol, Shanghai 200040, Peoples R China.
[2]Fudan Univ, Shanghai Med Coll, Huashan Hosp North, Shanghai 200040, Peoples R China.
[3]Tongji Univ, Shanghai Peoples Hosp 10, Dept Resp Med, Shanghai 200092, Peoples R China.
(8.0+极速模式)