Objective: Daprodustat is a novel oral agent in treating anemia of chronic 
kidney disease (CKD), and several clinical trials have been conducted to compare 
daprodustat with recombinant human erythropoietin (rhEPO) or placebo. Our 
systematic review aimed to investigate the efficacy and safety of daprodustat 
for anemia treatment in both dialysis-dependent (DD) and non-dialysis-dependent 
(NDD) patients. Methods: Six databases were searched for randomized controlled 
trials (RCTs) reporting daprodustat vs. rhEPO or placebo for anemia patients in 
CKD. The outcome indicators were focused on hemoglobin (Hb), ferritin, 
transferrin saturation (TSAT), total iron-binding capacity (TIBC), vascular 
endothelial growth factor (VEGF), and serious adverse events (SAEs). Results: 
Eight eligible studies with 1,516 participants were included. For both NDD and 
DD patients, changes in Hb levels from baseline were significantly higher in 
daprodustat group than that in the placebo (mean difference (MD) = 1.73, [95% 
confidence interval (CI), 0.34 to 3.12], p = 0.01; MD = 1.88, [95% CI, 0.68 to 
3.09], p = 0.002; respectively), and there was no significant difference between 
daprodustat and rhEPO group (MD = 0.05, [95% CI, -0.49 to 0.59], p = 0.86; MD = 
0.12, [95% CI, -0.28 to 0.52], p = 0.55; respectively). The indexes of iron 
metabolism were improved significantly in the daprodustat group compared to 
placebo- or rhEPO-treated patients, while there was no similar change in terms 
of TSAT for DD patients. Furthermore, no trend of increasing plasma VEGF was 
observed in daprodustat-treated subjects. As for safety, there was no 
significant difference in the incidence of SAEs between daprodustat and placebo 
treatment, while the incidence of SAEs in the daprodustat group was 
significantly lower than that in the rhEPO group. Conclusion: Daprodustat was 
efficacious and well tolerated for anemia in both NDD and DD patients in the 
short term based on current RCTs. And daprodustat may become an effective 
alternative for treatment of anemia with CKD. Since the application of 
daprodustat is still under exploration, future researches should consider the 
limitations of our study to evaluate the value of daprodustat.