Abstract
AIM: To evaluate the efficacy and safety of colestilan as a phosphorus binder in dialysis patients, we performed a meta-analysis of randomized controlled trials. METHODS We retrieved studies that compared colestilan with placebo in the treatment of dialysis patients from Medline, EMBASE, the Cochrane Library and conference proceedings. RESULTS Four 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, -0.22 mmol/L; 95% CI, -0.33 to -0.12, P < 0.0001), calcium phosphorus product (WMD, -0.70 mmol(2) /L(2) ; 95% CI, -1.06 to -0.35, P = 0.0001), intact PTH (WMD, -5.37 pmol/L; 95% CI, -8.38 to -2.36, P = 0.0005) and LDL cholesterol (WMD, -0.78 mmol/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 3 g/day colestilan, the results did not change. CONCLUSIONS Short-term administration of colestilan is effective for the treatment of hyperphosphataemia in dialysis patients. Long-term effectiveness and safety needs to be evaluated.
