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首页> 外文期刊>GaBi journal. >Retrospective chart review: disrupted anaemia control in haemodialysis patients following the switch to an iron sucrose similar (ISS) after long-term treatment with the originator iron sucrose (IS)
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Retrospective chart review: disrupted anaemia control in haemodialysis patients following the switch to an iron sucrose similar (ISS) after long-term treatment with the originator iron sucrose (IS)

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Study objective:To describe and compare the haematological parameters and the anaemia medication use in haemodialysis patients who were switched from the originator iron sucrose (IS) to an iron sucrose similar (ISS).Methods: A retrospective observational single-centre study describing chronic haemodialysis patients with anaemia and iron deficiency: the study compares patients being treated with erythropoiesis-stimulating agents (ESA) and the original intravenous IS (Venofer~R) or an ISS (Fer Mylan~R). This switch was performed for economic reasons, and without the knowledge of the treating physicians, by the hospital pharmacy. The analysis compared anaemia management in 66 chronic haemodialysis patients from three consecutive 26-week IS treatment periods (P1, P2 and P3) to a fourth 26-week ISS period (P4). ESA (darbepoetin alfa DA) was prescribed IV once every two weeks and IV iron was given once weekly. Haemoglobin (Hb) was assessed every two weeks, while serum ferritin, transferrin saturation (TSAT), and C-reactive protein (CRP) were collected twice per period.Results: Sixty-six patients (68 male) with an average age of 60 + 15 years were analysed where diabetes was the most common underlying cause of renal disease (33.3). Mean Hb levels remained stable and within the target range during treatment with IS (11.8 ± 1.0 g/dL) (PI to P3) but decreased significantly after the switch to ISS (11.3 ± 0.9 g/dL) (P4) (p < 0.001). During the same P1 to P3 periods TSAT also remained stable (43.7 ± 8.5 ) but decreased during ISS period (23.9 ± 9.5 ). Similar changes were observed for ferritin (627 ± 360 mug/L versus 504 ± 286 mug/L, p < 0.004). There was a statistically non-significant increase in CRP during period P4. Cumulative ESA and IV iron doses which were stable during P1 to P3 had to be increased by 27.1 and 30.3 respectively during P4; resulting in a 27.3 mean increase in the total cost per patient for these medications between P3 to P4.Conclusion: The switch from IS to ISS preparation led to destabilization of this previously well-controlled population of HD patients that also resulted in an increase in total anaemia drug treatment costs. Caution should be exercised before substituting IS with ISS in the absence of therapeutic equivalence data.

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