Aranesp use has increased from 2.5% in January 2014 to 21% in December 2015, while epoetin alfa use has fallen from 97.5% in January 2014 to 49.3% in December 2015.
Researchers from the Dialysis Outcomes and Practice Patterns Study (DOPPS) Practice Monitor (DPM) will host a web conference on Thursday, May 5 at 3 p.m. EDT. (Register here). The discussion will cover the latest trends in U.S. hemodialysis data from the DPM through December 2015, with a special focus on recent changes in erythropoiesis stimulating agent (ESA) use. The following trends come from the Dialysis Outcomes and Practice Patterns Study (DOPPS) Practice Monitor (DPM) U.S. hemodialysis data from the DPM through December 2015.
Increases in pegylated epoetin beta (Mircera) and darbepoetin (Aranesp) use. For over two decades, epoetin alfa has been the most commonly prescribed ESA (>90%) among US dialysis patients. Pegylated epoetin beta use was first identified in the March 2015 DPM cross-section and has rapidly risen to 29.7% of ESA-treated patients in December 2015. Darbepoetin use has also increased from 2.5% in January 2014 to 21% in December 2015, while epoetin alfa use has fallen from 97.5% in January 2014 to 49.3% in December 2015. Pegylated epoetin beta use was almost exclusively observed within the large dialysis organization (LDO) sample. Darbepoetin use increased in both the LDO and non-LDO sample. Overall, ESA use in the last three months (~90% of patients) and hemoglobin levels have remained stable. The DPM will continue to follow trends.
Update on serum potassium levels and potassium-binding resins. The DPM now reports serum potassium levels as well as the use of potassium-binding resins (e.g. kayexalate). In December 2015, severe hypokalemia (<3.5 mEq/l) was rare (0.4%) while 8.2% of patients had hyperkalemia (5.5+ mEq/L) which has remained largely unchanged since August 2010. Potassium-binding resins, which are used to decrease high potassium levels, are prescribed for only 2-3% of patients. By contrast, potassium-binding resins are prescribed for a much higher proportion of HD patients in some European DOPPS countries.
Patient-reported quality of life. Responding to the nephrology community, the DPM now provides patient-reported quality of life (QOL) data for download, including the Mental Composite Summary (MCS) and Physical Composite Summary (PCS) score distributions from the KDQOL-36© (Hays, 1994) for the DPM US national sample.
US DPM data cover August 2010 through August 2014, a time period of substantial change in clinical practice with potential implications for patient-reported QOL. Given current requirements for U.S. dialysis facilities to collect patient-reported outcomes, QOL score distributions reported in the DPM may prove useful for comparison purposes for patients, providers, and other stakeholders.
DPM researchers will cover a wide range of topics presented at DOPPS.org/DPM in the form of more than 1,500 regularly updated charts, figures, and data tables.
About the DPM: The DPM is based on a sample of over 11,000 patients in more than 200 US hemodialysis facilities. Research papers describing DPM methods, key recent findings and analysis, and commentary have been published. To learn more, please visit DOPPS.org/DPM.
About the DOPPS: Launched in 1996, the DOPPS is a prospective cohort study investigating practices related to the best outcomes for hemodialysis patients in over 20 countries. To learn more about the DOPPS