Anemia managers placing more emphasis on IV iron

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EXTON, Pa.— Anemia managers for dialysis patients are more likely to report that they are using lower average doses of erythropoiesis-stimulating agents, monitoring hemoglobins more frequently and placing more emphasis on a patient's IV iron status, according to a report released Sept. 11.

BioTrends Research Group’s report focuses on the management of renal anemia, including the use of ESAs and IV iron. “TreatmentTrends: Anemia Managers” is the first report the research company has conducted with anemia managers. It is based on the results of an online survey completed by 150 anemia managers—100 working with dialysis patients and 50 working with later stage chronic kidney disease patients. In addition, the report includes qualitative interviews with a subset of 25 respondents.

Dialysis and Anemia Management

In dialysis, anemia managers are very involved in monitoring lab values related to ESA and IV iron use and making therapy decisions based on labs and protocols, according to BioTrends. Similar to nephrologists, the report found that a vast majority of anemia managers report that ESA safety issues have impacted their use of ESAs in dialysis.

Anemia managers and nephrologists most often report protocol changes and ESA dose reductions at lower hemoglobin levels as types of changes, according to the report. However, anemia managers were more likely to report that they are using lower average doses of ESAs, monitoring hemoglobins more frequently, and placing more emphasis on a patient's IV iron status.

In addition, anemia managers predict a significant increase in their use of IV iron in the next three months, according to BioTrends. More than one-third report changing their IV iron protocol in the past three months—most often allowing higher levels of ferritin before holding IV iron and making more effort to keep patients on maintenance therapy (by extending dosing frequency, for example) instead of discontinuing therapy. The report also found that American Regent's Venofer is the market share leader in the IV iron hemodialysis market over Watson's Ferrlecit.

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