Kidney Week

Abstract: TH-OR10

A Real-World Longitudinal Analysis of Anemia Treatment Prescriptions in Non-Dialysis-Dependent CKD Patients, a CKDopps Study

Session Information

• Breakthroughs in Anemia and Iron Management
  October 22, 2020 | Location: Simulive
  Abstract Time: 05:00 PM - 07:00 PM

Category: Anemia and Iron Metabolism

• 200 Anemia and Iron Metabolism

Authors

• Lopes, Marcelo, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Marcelo Lopes, MD, PhD, MPH



Nephrologist, ISN Scholar. Epidemiologist with MPH through the School of Public Health, University of Michigan. Research Analyst, Arbor Research Collaborative for Health.

• Tu, Charlotte, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Charlotte Tu,

• Zee, Jarcy, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Jarcy Zee,

• Guedes, Murilo Henrique, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Murilo Henrique Guedes,

• Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Ronald L. Pisoni,

• Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Bruce M. Robinson,

• Hedman, Katarina, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Katarina Hedman,

• James, Glen, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Glen James,

• Sloand, James A., AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

James A. Sloand,

• Massy, Ziad, Universite Paris-Saclay, Villejuif, France

Ziad Massy,

• Lopes, Antonio Alberto, Universidade Federal da Bahia, Salvador, BA, Brazil

Antonio Alberto Lopes,

• Reichel, Helmut, Nephrological Center, Villingen Schwenningen, Germany

Helmut Reichel,

• Wachter, Sandra, Vifor Pharma Ltd, Glattbrugg, Zurich, Switzerland

Sandra Wachter,

• Wong, Michelle M.Y., The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada

Michelle M.Y. Wong,

• Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Roberto Pecoits-Filho,

Group or Team Name

• DOPPS

Background

Previously lacking in the literature, this analysis aims to comprehensively describe longitudinal patterns of anemia management, including prescriptions of ESA and iron replacement, for non-dialysis dependent chronic kidney disease (NDD-CKD) stage 3 to 5 patients under nephrologist care.

Methods

We analyzed data from a prospective cohort of 2455 NDD-CKD patients from Brazil, Germany and the US, who were not using anemia medications (oral iron, intravenous [IV] iron, or erythropoiesis stimulating agent [ESA]) at enrollment in the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDOPPS). We reported the cumulative incidence function (CIF) [HK1] of anemia treatment initiation, stratified by patient characteristics. For patients that started therapy, we report the frequency of medication type at the moment of initiation, as well as switches and discontinuation over 12 months.

Results

The CIF of any anemia treatment initiation at 12 months was 54% for patients with Hb <10 g/dL. For oral iron therapy, the CIF at 12 months was 26% (19%, 32%) for TSAT<20%, and 22% (17%, 28%) for ferritin <100. For IV iron use, CIF at 12 months was 6% (3%, 11%) for patients with TSAT<20% and 4% (2%, 7%) for patients with ferritin <100ng/mL. For ESA use, the CIF at 12 months was 38% (29%, 47%) for patients with Hb <10 g/dL, and 11% (8%, 14%) for Hb 10 to <12 g/dL. Medication types at initiation and longitudinal treatment patterns (switches and discontinuation) are shown in the figure.

Conclusion

In a period of 12 months, anemia medication is initiated in a limited number of NDD-CKD patients with clinical signs that would indicate to do so. This longitudinal analysis using data from the real-world setting, call attention to a sub-optimally management of anemia in the NDD CKD setting.

Anemia medication starts and switches within a year of follow-up.