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BioTrends Report Based On Patient Chart Data Uncovers Current Practices In The Management Of Renal Anemia Among Chronic Kidney Disease Patients

May 29, 2019

BioTrends Research Group, Inc. released ChartTrends®: Renal Anemia in Chronic Kidney Disease Non-Dialysis (CKD-ND), an annual syndicated publication based on patient and laboratory data collected from over 1,000 US CKD-ND patient charts. ChartTrends® compare what physicians self-report about disease management to what actually occurs at the patient level. This report evaluates the management of renal anemia including patient characteristics, demographics, lab values, co-morbidities and concomitant medications that drive both decisions to treat and brand selection of erythropoietin stimulating agents (ESAs) and intravenous (IV) iron. Brand use dynamics such as dosing (including dosing interval and titration), persistency, administration location, brand switching and reasons for switching are also evaluated.

Both the percent of CKD-ND patients treated with ESAs and the mean hemoglobin at initiation of ESAs have decreased significantly compared to last year. While in prior years, the vast majority of IV iron treated patients were on ESAs, this year, those numbers have decreased. There are a number of patient characteristics that distinguish ESA treated vs. non-treated patients; a higher percent of treated patients have hypertension, type 2 diabetes and congestive heart failure, to name a few. Despite treatment, close to one-third of patients are not managed to goal (have hemoglobin levels less than 10g/dL). ESA dose tends to increase as kidney disease worsens but average monthly dose for epoetin alfa (Centocor Ortho-Biotech's Procrit, Amgen's Epogen) has declined compared to the prior year.

In terms of IV iron, nephrologists tend to over-report the percent of their CKD-ND patients that are treated, although compared to last year, there is an increasing trend in the percent of stage 4 and 5 patients that are on IV iron. The majority of patients treated with IV iron tend to graduate from oral iron. Lack of testing appears to be an issue that may be preventing increased use of IV iron; while almost all patients have a hemoglobin in their record, a much smaller percent have a TSAT or ferritin level in their chart. Hemoglobin levels are also measured more frequently than iron studies. While nephrologists report initiating IV iron at a TSAT of 19 percent, the audited TSAT at IV iron initiation is in fact lower. From a brand perspective, the percent of patients on AMAG's Feraheme has increased significantly compared to last year, although American Regent's Venofer remains the market share leader.

Source: BioTrends Research Group, Inc

View drug information on Feraheme; Venofer.