Journal
EXPERT OPINION ON EMERGING DRUGS
Volume 18, Issue 4, Pages 421-429Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/14728214.2013.836490
Keywords
anemia; chronic kidney disease; erythropoietin; peginesatide
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Funding
- National Cancer Institute [1R01CA165609-01A1]
- South Carolina Center of Economic Excellence Center for Medication Safety initiative
- Doris Levkoff Meddin Medication Safety Program
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Introduction: Erythropoiesis-stimulating agents (ESAs) prevent transfusions among anemic patients with chronic kidney disease (CKD). Clinical trials, meta-analyses, and guidelines identify arterial and venous thromboembolism as well as myocardial event risks with the traditional ESAs, erythropoietin (EPO), and darbepoietin. Side effects of anemia treatment, considering frequency and dosage of treatment as well as targeted hemoglobin levels when utilizing ESAs, greatly impact overall well-being and the quality of life. There is a need for less frequent but equally effective ESAs in this setting. Areas covered: The three generations of ESAs used in CKD-associated anemia are described. Cost effectiveness of the utilization of these therapies, in addition to emerging therapies, is also presented. The few clinical and controlled trials only highlight the need for clarity in molecular biology surrounding the components that control EPO levels and utilization. Expert opinion: Anemia associated with CKD is an important area for development of newer therapies which are potentially safer and more convenient to administer.
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