Sodium thiosulphate incapable of managing calciphylaxis in CKD patients: JAMA

Calciphylaxis is a rare disease. It has high mortality in CKD patients. Sodium thiosulphate (STS) is used as an off-label therapeutic, but there needs to be more data to confirm the same. The question is whether STS is tied to improvement in skin lesions and survival in CKD patients with calciphylaxis.

Considering this, researchers performed a meta-analysis and obtained data from PubMed, Embase, Cochrane Library, and Web of Science using relevant terms and measured Skin lesion improvement and survival as the primary outcome.

The study results include the following:

• Eligibility criteria were met by 19 retrospective cohort studies with 422 patients of mean age, 57 years, including 37.3% male.
• There was no difference in skin lesion improvement between the STS and the comparator groups.
• There was no reported difference in risk of death and overall survival using time-to-event data.
• In meta-regression, lesion improvement tied to STS negatively correlated with publication year. This implies that recent studies are more likely to report a null association than past studies.

The study limitations were related to data collection, bias from multiple sources, and some important outcomes were not analyzed.

They said, “Based on study results, intravenous STS on CKD patients experiencing calciphylaxis does not pose any improvement in skin lesion outcomes or survival.

Future studies are urgently warranted for evaluating therapies.

Further reading:

Wen W, Portales-Castillo I, Seethapathy R, et al. Intravenous Sodium Thiosulphate for Calciphylaxis of Chronic Kidney Disease: A Systematic Review and Meta-analysis. JAMA Netw Open. 2023;6(4):e2310068. doi:10.1001/jamanetworkopen.2023.10068