BURLINGTON, Mass., Dec. 1, 2014 /PRNewswire/ -- Decision Resources Group finds that, based on a review of 1,000 charts for chronic kidney disease non-dialysis (CKD-ND) patients, audited treatment rates related to the use of key renal medications differ from nephrologist-reported treatment rates in 5 out of 7 drug classes studied. This outcome was true for either stage 3, stage 4 and/or stage 5 CKD-ND patients among erythropoietin stimulating agents (ESAs), IV iron, oral iron, phosphate binders, active vitamin D (AVD), nutritional Vitamin D (NVD) or calcimimetic agents.
Other key highlights from the report entitled Chart Trends Renal Anemia in Chronic Kidney Disease Non-Dialysis (US) 2014:
- Most recent and/or monthly laboratory parameters: Considering the 22 laboratory parameters covered in the report, the vast majority of CKD-ND patient charts show recent measures for glomerular filtration rate, hemoglobin, blood pressure, calcium, creatinine, potassium, and phosphorus, while other values are not as likely to have a recent measure.
- Laboratory parameters at referral to a nephrologist: The percentage of patient records with labs at referral to a nephrologist also varies by lab parameter. According to information from patient charts, patients tend to have significantly higher potassium levels at referral than they do at their most recent lab test.
- Diabetes management in CKD: The percentage of CKD caused primarily by diabetes increased significantly between 2012 and 2014. As a result, Decision Resources Group's analysis has been expanded to include the use of diabetes medications in CKD-ND patients; including the use of insulin only, other diabetic medications only, both insulin and other diabetic medications, or neither insulin or other diabetic medications.
- Medication initiation and crossovers: Not surprisingly, the use of most renal medications increases as CKD worsens. The report details hemoglobin at ESA initiation and phosphorus at phosphate binder initiation, among other laboratory values at medication initiation and also compares reported versus audited values.
- Patient profiles: Key variations also exist between treated and non-treated patient groups. For example, patients taking ESAs tend to be in a later CKD stage and are more likely to have certain comorbidities and have lower hemoglobin and transferrin saturation levels, compared with patients who are not taking ESAs. These and other aspects of treated versus non-treated patients are summarized through nine different patient profile analyses.
- Patient share: Shifts in 2014 include ongoing gains for Ferrlecit (Sanofi) in the IV iron market and the impact of new medications such as Velphoro (Vifor Fresenius Medical Care Renal Pharma) in the phosphate binder space. Current and historical patient share data are analyzed for all key renal medication classes including ESAs, IV iron, phosphate binders, NVD and AVD.
Comments from Decision Resources Group Director Rob Dubman:
- "New to this report, we found that a significant portion of CKD-ND patients are candidates for oral hypoxia inducible factor-prolyl hydroxylase (HIF-PH) inhibitors in development. After review of a product profile, nephrologists were asked if either roxadustat (FibroGen/Astellas/AstraZeneca), AKB-6548 (Akebia Therapeutics), or GSK-1278863A (GlaxoSmithKline) would likely be prescribed to a particular patient if FDA approved, and if so, what—if anything—would happen to their current ESA use. This methodology allows manufactures to see at what hemoglobin level, for example, physicians would initiate therapy for their product, along with a patient profile."
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