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Abstract: PO0472

Estimating Long-Term Survival Rates in Patients with Anaemia of Non-Dialysis-Dependent CKD: An Expert Elicitation

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Garcia Sanchez, Juan Jose, AstraZeneca PLC, Cambridge, Cambridgeshire, United Kingdom
  • Ouwens, Johannes Nicolaas Martinus, AstraZeneca AB, Mölndal, Sweden
  • Willigers, Bart J.a., AstraZeneca PLC, Cambridge, Cambridgeshire, United Kingdom
  • Briggs, Andrew, London School of Hygiene & Tropical Medicine, London, London, United Kingdom
  • Darlington, Oliver, Health Economics and Outcomes Research Ltd, Cardiff, United Kingdom
  • Bhatt, Purav Rahulkumar, AstraZeneca, Wilmington, Delaware, United States
  • Wittbrodt, Eric T., AstraZeneca, Wilmington, Delaware, United States
  • Sinsakul, Marvin, AstraZeneca, Wilmington, Delaware, United States
  • Grandy, Susan, AstraZeneca, Wilmington, Delaware, United States
  • L Heerspink, Hiddo Jan, The University of Groningen, Groningen, Netherlands
  • Pollock, Carol A., The University of Sydney, Sydney, New South Wales, Australia
  • Pecoits-Filho, Roberto, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Tangri, Navdeep, The University of Manitoba, Winnipeg, Manitoba, Canada
  • Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Wheeler, David C., University College London, London, London, United Kingdom
Background

Clinical trials for the treatment of anemia of CKD provide mortality data. Cost-effectiveness analyses of new treatments require survival extrapolations over a lifetime time horizon. An expert elicitation was conducted to obtain estimates of long-term survival probabilities for patients with anemia of non-dialysis dependent (NDD) CKD.

Methods

Literature searches were used to identify clinical trials and observational studies that included patients with anemia of NDD CKD aged ≥ 18 years, that had > 500 participants per study arm and that reported all-cause death incidence and/or survival Kaplan–Meier (KM) curves. Study data were extracted and collated. KM curves were extrapolated to 20 years by calculating standardized mortality ratios (SMRs) compared to age- and sex-adjusted general population lifetables. A summary of relevant data was presented to six CKD experts. After an elicitation training, the experts made a judgment on the 10th, 50th and 90th percentile of 10- and 20-year survival of patients with anemia of NDD CKD. The individual judgments were combined into an overall assessment.

Results

From the literature, all-cause death incidence in patients with anemia of NDD CKD was 3.5–39.4 per 100 patient-years (five studies). From SMR-extrapolated KM curves, estimated survival at 10 and 20 years was 30–57% and < 1–13%, respectively (three studies; median age of 80 and 68 years in two studies, and mean age of 66 in the third). The aggregated elicited survival values were 50% (80% confidence interval [CI]: 34–64%) at 10 years and 21% (80% CI: 8–36%) at 20 years.

Conclusion

The elicited survival estimates could be used to model long-term survival and complement results from other extrapolation methods to inform and validate cost-effectiveness analyses. Long-term survival extrapolations are also likely to support patients and physicians with treatment decisions.

Funding

  • Commercial Support