Comparison of Different Types of Oral Adsorbent Therapy in Patients with Chronic Kidney Disease: A Multicenter, Randomized, Phase IV Clinical Trial
- 주제(키워드) Chronic kidney disease , AST-120 , DW-7202 , preference , adherence
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Kee, Youn Kyung] Kangdong Sacred Heart Hosp, Dept Internal Med, Seoul, South Korea; [Han, Sang Youb] Inje Univ, Coll Med, Ilsan Paik Hosp, Dept Internal Med, Goyang, South Korea; [Kang, Duk-Hee] Ewha Womans Univ, Sch Med, Ewha Med Res Ctr, Dept Internal Med,Div Nephrol, Seoul, South Korea; [Noh, Jung Woo] Hallym Univ, Coll Med, Kangnam Sacred Heart Hosp, Dept Internal Med, Seoul, South Korea; [Jeong, Kyung Hwan] Kyung Hee Univ, Dept Internal Med, Div Nephrol, Seoul, South Korea; [Kim, Gheun-Ho] Hanyang Univ, Coll Med, Dept Internal Med, Div Nephrol, Seoul, South Korea; [Kim, Yang Wook] Inje Univ, Coll Med, Haeundae Paik Hosp, Dept Internal Med, Busan, South Korea; [Kim, Beom Seok] Yonsei Univ, Coll Med, Dept Internal Med, 50-1 Yonsei Ro, Seoul 03722, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 Green Published, gold
- 발행기관 YONSEI UNIV COLL MEDICINE
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000175420
- 본문언어 영어
- Published As http://dx.doi.org/10.3349/ymj.2021.62.1.41
- PubMed https://pubmed.ncbi.nlm.nih.gov/33381933
초록/요약
Purpose: Oral adsorbents delay disease progression and improve uremic symptoms in patients with chronic kidney disease (CKD). DW-7202 is a newly developed oral adsorbent with high adsorptive selectivity for uremic toxins. We evaluated patient preference for and adherence to DW-7202 versus AST-120 therapy and compared treatment efficacy and safety in patients with pre-dialysis CKD. Materials and Methods: A seven-center, randomized, open-label, two-way crossover, active-controlled, phase IV clinical trial was conducted. Patients with stable CKD were randomly assigned to receive DW-7202 (capsule type) or AST-120 (granule type) for 12 weeks. The groups then switched to the other adsorbent and took it for the next 12 weeks. Patient preference was the primary outcome. Secondary outcomes included changes in estimated glomerular filtration rate (eGFR) and serum creatinine, cystatin C, and indoxyl sulfate (IS) levels. Results: Significantly mom patients preferred DW-7202 than AST-120 (p<0.001). Patient adherence improved after switching from AST-120 to DW-7202; there was no apparent change in adherence after switching from DW-7202 to AST-120. Changes in eGFR and serum creatinine, cystatin C, and IS levels were not significantly different according to adsorbent type. There was also no significant difference in the incidences of adverse events during treatment with DW-7202 and AST-120. Conclusion: DW-7202 can be considered as an alternative to AST-120 in patients who cannot tolerate or show poor adherence to granule type adsorbents. Further studies to evaluate factors affecting patient preferences and improved adherence are warranted.
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