-Author name in bold denotes the presenting author
-Asterisk * with author name denotes a Non-ASH member
Clinically Relevant Abstract denotes an abstract that is clinically relevant.

PhD Trainee denotes that this is a recommended PHD Trainee Session.

Ticketed Session denotes that this is a ticketed session.

3399 A Real World Longitudinal Analysis of Anemia Treatment Prescriptions in Non-Dialysis-Dependent Chronic Kidney Disease Patients, a CKDopps Study

Program: Oral and Poster Abstracts
Session: 901. Health Services Research—Non-Malignant Conditions: Poster III
Hematology Disease Topics & Pathways:
CRS, Anemias, Adult, Diseases, Study Population, Clinically relevant
Monday, December 7, 2020, 7:00 AM-3:30 PM

Marcelo Barreto Lopes1*, Charlotte Tu1*, Jarcy Zee1*, Murilo H. Guedes2*, Ronald L. Pisoni1*, Bruce M. Robinson1*, Katarina Hedman3*, Glen James4*, James A. Sloand5*, Ziad Massy6*, Antonio A. Lopes7*, Helmut Reichel8*, Sandra Wächter9*, Michelle M. Wong10* and Roberto Pecoits-Filho1*

1Arbor Research Collaborative for Health, Ann Arbor, MI
2Pontificia Universidade Catolica do Parana, Curitiba, Brazil
3AstraZeneca, Gothenburg, Sweden
4AstraZeneca, Cambridge, United Kingdom
5AstraZeneca, Gaithersburg, MD
6Universite Paris-Saclay, Villejuif, France
7Universidade Federal da Bahia, Salvador, Brazil
8Nephrological Center, Villingen Schwenningen, Germany
9Vifor Pharma Ltd, Glattbrugg, Switzerland
10The University of British Columbia Faculty of Medicine, Vancouver, BC, Canada

Background: Previously lacking in the literature, this analysis aims to comprehensively describe longitudinal patterns of anemia management, including prescriptions of erythropoiesis-stimulating agent (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 ESA) at enrollment in the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps). We reported the cumulative incidence (CI) 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 CI of any anemia treatment initiation at 12 months was 54% for patients with Hb <10 g/dL. For oral iron therapy, the CI at 12 months was 26% (19%, 32%) for transferrin saturation (TSAT) <20%, and 22% (17%, 28%) for ferritin <100 ng/mL. For IV iron use, CI at 12 months was 6% (3%, 11%) for patients with TSAT <20% and 4% (2%, 7%) for patients with ferritin <100 ng/mL. For ESA use, the CI 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 supports the concept that anemia is sub-optimally managed among patients with NDD CKD in the real-world setting.

Disclosures: Barreto Lopes: AstraZeneca: Research Funding. Tu: Arbor Research Collaborative Health: Current Employment. Zee: Arbor Research Collaborative for Health: Current Employment. Pisoni: AstraZeneca: Research Funding. Robinson: Arbor Research Collaborative for Health: Current Employment. Hedman: AstraZeneca: Current Employment, Current equity holder in private company. James: AstraZeneca: Current Employment, Current equity holder in private company. Sloand: AstraZeneca: Current Employment, Current equity holder in private company. Massy: Amgen: Research Funding; Baxter: Research Funding; Fresenius Medical Care: Research Funding; GlaxoSmithKline: Research Funding; Merck Sharp and Dohme-Chibret: Research Funding; Sanofi-Genzyme: Research Funding; Lilly: Research Funding; Otsuka: Research Funding. Lopes: Arbor Research Collaborative for Health: Current Employment. Reichel: Vifor: Consultancy, Honoraria. Wächter: Vifor Pharma Int: Current Employment. Pecoits-Filho: Fresenius Medical Care: Research Funding; Akebia: Consultancy; AstraZeneca: Consultancy.

*signifies non-member of ASH