PROSPERO International prospective register of systematic reviews
Comparative effectiveness and safety of phosphate binders in patients with chronic
kidney disease: a protocol for a systematic review and network meta-analysis
Nigar Sekercioglu, Gordon Guyatt, Lehana Thabane, Gihad Nesrallah, Jason Busse, Alfonso Iorio, Noori Akhtar-Danesh
Citation
Nigar Sekercioglu, Gordon Guyatt, Lehana Thabane, Gihad Nesrallah, Jason Busse, Alfonso Iorio, Noori AkhtarDanesh. Comparative effectiveness and safety of phosphate binders in patients with chronic kidney disease: a
protocol for a systematic review and network meta-analysis. PROSPERO 2016:CRD42016032945 Available from
http://www.crd.york.ac.uk/PROSPERO_REBRANDING/display_record.asp?ID=CRD42016032945
Review question(s)
The objective of this systematic review is to combine direct and indirect estimates of treatment effects of phosphate
binders for patient-important outcomes in patients with hyperphosphatemia and CKD. We will employ the GRADE
methodology to report our confidence in effect estimates for each outcome and aimed to update the most recent
systematic review which included lanthanum and sevelamer as well as calcium-based phosphate binders. We will also
include iron-based phosphate binders in this review.
Searches
We will search the MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases
from January 2013 until August2015 without any restrictions. We will use controlled vocabulary and text words to
search all databases and restrict our search to randomized controlled trials (RCT).
Types of study to be included
Randomized controlled trials.
Condition or domain being studied
The chronic kidney disease-mineral and bone disorder (CKD-MBD) has been linked to poor health outcomes,
including diminished quality and length of life. The condition is characterized by high phosphate levels and requires
phosphate lowering agents—phosphate binder.
Participants/ population
The population is CKD patients with hyperphosphatemia
Intervention(s), exposure(s)
The drug treatments will include calcium-based phosphate binders (calcium acetate, calcium citrate and calcium
carbonate) and non-calcium-based phosphate binders (sevelamer hydrochloride, sevelamer carbonate, lanthanum
carbonate, sucroferric oxyhydroxide andferric citrate).
Comparator(s)/ control
The drug treatments will include calcium-based phosphate binders (calcium acetate, calcium citrate and calcium
carbonate) and non-calcium-based phosphate binders (sevelamer hydrochloride, sevelamer carbonate, lanthanum
carbonate, sucroferric oxyhydroxide andferric citrate).
Outcome(s)
Primary outcomes
Mortality
Secondary outcomes
Treatment effects, including effectiveness and safety
Page: 1 / 3
Risk of bias (quality) assessment
We will assess the certainty in effect estimates for each outcome as high, moderate, low or very low using the
GRADE (Grading of Recommendations, Assessment, Development and Evaluation) rating system. In the GRADE
system, RCTs begin as high quality evidence, but may be rated down by one or more of five categories of limitation.
We will use the detailed GRADE guidance to assess overall risk of bias, imprecision, inconsistency, indirectness and
publication bias and summarize results with a GRADE summary table.
Strategy for data synthesis
We will use aggregate data to perform network meta-analysis and our inferences will be based on arm-level format
(not contrast-level format).We will synthesise the results from RCTs using Bayesian hierarchical random effect
models.
Analysis of subgroups or subsets
None planned.
Contact details for further information
Dr Sekercioglu
1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
[email protected]
Organisational affiliation of the review
McMaster University
Review team
Dr Nigar Sekercioglu,
Dr Gordon Guyatt,
Dr Lehana Thabane,
Dr Gihad Nesrallah,
Dr Jason Busse,
Dr Alfonso Iorio,
Dr Noori Akhtar-Danesh,
Anticipated or actual start date
01 January 2016
Anticipated completion date
31 March 2016
Funding sources/sponsors
None.
Conflicts of interest
None known
Language
English
Country
Canada
Subject index terms status
Subject indexing assigned by CRD
Page: 2 / 3
Subject index terms
Humans; Hyperphosphatemia; Phosphates; Renal Insufficiency, Chronic
Stage of review
Ongoing
Date of registration in PROSPERO
13 January 2016
Date of publication of this revision
13 January 2016
Stage of review at time of this submission
Preliminary searches
Piloting of the study selection process
Formal screening of search results against eligibility criteria
Data extraction
Risk of bias (quality) assessment
Data analysis
Started
Completed
Yes
Yes
No
No
No
No
No
No
No
No
No
No
PROSPERO
International prospective register of systematic reviews
The information in this record has been provided by the named contact for this review. CRD has accepted this information in good
faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record,
any associated files or external websites.
Page: 3 / 3
Powered by TCPDF (www.tcpdf.org)