Comparative Effectiveness and Safety of Newer Agents for Anemia Treatment in HD

治疗 HD 贫血的新型药物的有效性和安全性比较

• 批准号: 9038583
• 负责人: WOLFGANG CHRISTOPH WINKELMAYER
• 金额: $ 33.16万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-25 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9038583
• 关键词: Comparative; Effectiveness; Safety; Newer; Agents

DESCRIPTION (provided by applicant): More than 575,000 Americans have end-stage renal disease, which is typically complicated by anemia, and most of these patients receive maintenance dialysis treatment. The proposed work will compare the effectiveness and safety of darbepoetin alfa, a novel injectible drug for the treatment of anemia, with its established cousin, epoetin alfa. Similarly, ferumoxytol, a new intravenous iron supplement for the treatment of anemia will be compared with an established iron supplement, iron sucrose. Both drugs were approved using information from randomized studies that evaluated their efficacy on reducing anemia. Very limited information, however, is available for either drug regarding their longer-term efficacy and safety. We are proposing to study the effectiveness and safety of these two medications when compared to their established cousins. Events of scientific interest include short-term outcomes (anaphylaxis, laboratory parameters including hemoglobin, iron saturation, ferritin) and longer- term outcomes including infection, cardiovascular events, cancer, and mortality. We will use already collected data from Medicare billing claims and electronic medical records of dialysis providers to address these research questions. Since facilities choose among these treatment options based on what is available in their formulary, and not necessarily based on patient characteristics, we can exploit natural experiments that occur when facilities switch their ESA or iron agent for their entire patient population. We will apply modern epidemiological techniques to eliminate bias and aspire to provide valid estimates of relative benefits and risks. Findings from the proposed work have the potential to immediately impact and improve the care that patients with end-stage renal disease receive. Our results may improve the quality of care received and, thus, the outcomes of this vulnerable patient population. The aims and scope of work are in full congruence with the mission of the National Institutes of Diabetes and Digestive and Kidney Diseases, and more specifically the Division of Kidney, Urologic, and Hematologic Diseases, which will consider this application for funding.

描述（由申请人提供）：超过575,000名美国人患有末期肾脏疾病，通常患有贫血复杂，大多数患者接受维持透析治疗。拟议的工作将比较darbepoetin alfa的有效性和安全性，darbepoetin alfa是一种新型的贫血治疗药物，其既定的表弟Epoetin alfa。同样，将比较一种用于治疗贫血的新型静脉静脉铁补充剂，将其与已建立的铁补充铁蔗糖进行比较。使用随机研究的信息批准了两种药物，这些信息评估了它们在减少贫血方面的疗效。但是，有关其长期疗效和安全性的药物的信息非常有限。 我们建议研究这两种药物与既定的表亲相比的有效性和安全性。科学感兴趣的事件包括短期结局（过敏反应，实验室参数，包括血红蛋白，铁饱和度，铁蛋白）以及包括感染，心血管事件，癌症和死亡率在内的长期结局。 我们将使用已经从Medicare账单索赔和透析提供者的电子病历中收集的数据来解决这些研究问题。由于设施在这些治疗方案中根据其配方中可用的东西选择，不一定是基于患者特征，因此我们可以利用当设施为整个患者群体切换其ESA或铁剂时发生的自然实验。我们将采用现代流行病学技术来消除偏见并渴望提供相对利益和风险的有效估计。 拟议工作的发现有可能立即影响并改善终末期肾脏疾病患者接受的护理。我们的结果可能会提高收到的护理质量，从而提高该脆弱患者人群的结果。工作的目的和范围与美国国立糖尿病，消化和肾脏疾病的使命完全一致，更具体地说是肾脏，泌尿科和血液学疾病的部门，这将考虑这项资金申请。

项目成果

Safety of Intravenous Iron in Hemodialysis: Longer-term Comparisons of Iron Sucrose Versus Sodium Ferric Gluconate Complex.

• DOI: 10.1053/j.ajkd.2016.10.031
• 发表时间: 2017-06
• 期刊: American journal of kidney diseases : the official journal of the National Kidney Foundation
• 作者: Winkelmayer WC;Goldstein BA;Mitani AA;Ding VY;Airy M;Mandayam S;Chang TI;Brookhart MA;Fishbane S
• 通讯作者: Fishbane S

Trends in anemia care in older patients approaching end-stage renal disease in the United States (1995-2010).

• DOI: 10.1001/jamainternmed.2014.87
• 发表时间: 2014-05
• 期刊: JAMA INTERNAL MEDICINE
• 影响因子: 39
• 作者: Winkelmayer, Wolfgang C.;Mitani, Aya A.;Goldstein, Benjamin A.;Brookhart, M. Alan;Chertow, Glenn M.
• 通讯作者: Chertow, Glenn M.