BioTrends Research Group, Inc. is pleased to announce the recent release of two syndicated reports focused on the management of renal anemia in the US. ChartTrends®: Renal Anemia is an annual publication based on patient and laboratory data collected from over 1,000 dialysis patient charts. It provides significant insight into the factors that drive decisions to treat, brand selection, dose and dose changes and switching behavior. TreatmentTrends®: US Nephrology is a quarterly report series based on online survey results from over 100 nephrologists and captures physician attitudes, perceptions and self-reported behavior.
Familiarity with Amgen's clinical trial, TREAT, has increased and approximately 90% of nephrologists are at least somewhat familiar with the study. Close to two-thirds report the study had led to changes or expected changes in their use of erythropoietin stimulating agents (ESAs) in chronic kidney disease non-dialysis (CKD-ND) patients; the study has also led to changes in anemia management in dialysis patients, albeit to a lesser extent. Impact appears to be on the ESA class as a whole, effecting both Amgen's Aranesp/Epogen and Centocor Ortho Biotech's Procrit. In addition to reports of the study's negative impact on ESA use, there has been a significant decrease in reported use of ESAs in CKD-ND patients compared to last quarter and nephrologists give significantly lower safety ratings to ESA products compared to IV iron products. Furthermore, reported hemoglobin at initiation for both CKD-ND and dialysis patients has decreased significantly compared to the prior year and audited figures suggest that hemoglobin level at ESA initiation in dialysis patients is even lower than the reported figure. Finally, nephrologists' predict a decreased use of ESAs in both the dialysis and CKD-ND setting in the next three months.
Despite reports and indications of decreased use of ESAs, there have not been any significant changes compared to last year in the percent of patients treated with IV iron. However, the percent of nephrologists who report stocking IV iron in their offices is trending up and managed care seems to be having more of an impact on increased use of IV iron in CKD-ND patients. American Regent's Venofer and AMAG's Feraheme are the most commonly stocked IV iron products and nephrologists have clear and distinct reasons for the choice of one over the other. Feraheme has been making significant gains among IV iron treated hemodialysis, peritoneal dialysis and CKD-ND patients since its launch in July. While Feraheme has been used in all market segments, uptake has been greatest in CKD-ND patients and penetration in hemodialysis has varied depending on dialysis unit affiliation. Fresenius' Venofer continues to be the market share leader across all dialysis unit types with Sanofi-Aventis' Ferrlecit (formerly marketed by Watson) in second position.
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