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Abstract: TH-OR10

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

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Lopes, Marcelo, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Tu, Charlotte, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Zee, Jarcy, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Guedes, Murilo Henrique, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Hedman, Katarina, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • James, Glen, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Sloand, James A., AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Massy, Ziad, Universite Paris-Saclay, Villejuif, France
  • Lopes, Antonio Alberto, Universidade Federal da Bahia, Salvador, BA, Brazil
  • Reichel, Helmut, Nephrological Center, Villingen Schwenningen, Germany
  • Wachter, Sandra, Vifor Pharma Ltd, Glattbrugg, Zurich, Switzerland
  • Wong, Michelle M.Y., The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

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.