Retrospective Review on the Use of Erythropoiesis-Stimulating Agents (ESAs) in a Local Hospital Setting

Abstract Description

Authors (including presenting author) :

Ho WY(1)

Affiliation :

(1)Department of Pharmacy, YCH

Introduction :

Erythropoiesis-stimulating agents (ESAs) are effective treatments of renal anemia. They aim to relieve symptoms and to avoid the need for blood transfusion. This helps to improve renal disease progression as well as the quality of life of patients. Despite its effectiveness, overcorrection of haemoglobin (Hb) concentration may increase the risk of cardiovascular events and related complications and even the risk of death. There is, however, uncertainty about the optimal Hb level for ESA therapy and guidelines recommend that Hb target should be individualized with regular monitoring.

Objectives :

(1) to evaluate the use of ESAs in a local hospital setting; (2) to review the maintained Hb levels and safety outcomes.

Methodology :

This is a retrospective medication use review that collects clinical data on patients who were initiated or prescribed with ESA therapy between 1 January 2011 and 31 December 2016 in Yan Chai Hospital (YCH). The follow-up period was 1 year after a 3-month titration period. Consultation notes, medication history, and laboratory data were retrieved from the electronic Patient Record (ePR). Data collection from eligible patient profiles was conducted in YCH pharmacy.

Result & Outcome :

56 Mircera patients, 25 Aranesp/Nesp patients and 3 Eprex patients were enrolled. Mircera (P <0.0001) and Aranesp/Nesp (P = 0.004) were found to effectively improve Hb level during the follow-up period. They showed no difference in the extent of ability to raise Hb level. Majority of the recruited subjects had a mean Hb level maintained at the range of 10-11.5g/dl. There was no ESA related adverse event recorded in ePR. ESA therapies were found to be effective and well tolerated by the local population. Risk and benefit of use should be considered before initiation and with proper treatment monitoring. As renal services would be the key expending area in the future, the use of ESA preparations is expected to increase.