Efficacy of frequent dosing of iron dextran on epogen dose and cost on a stable vs mixed maintenance hemodialysis (HD) population.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:219A 1997
The use of maintenance dosing of iv iron has gained popularity in recent years, based on the demonstration by 6 randomized trials that it decreases the required dose of EPO. This was a retrospective outcomes study comparing two methods of treating with i v iron dextran. In year one, all patient were treated with oral iron, and were given a course of iv iron dextran (100 mg X 10 doses) only if the TSAT fell to below 20%. In year two, patients were treated with iv iron dextran 25 mg per week. The study was conducted at 5 centers.
The interesting end result was that in year two costs of therapy were significantly reduced, with lower total doses for Epogen, and remarkably, for iron dextran also.
Comment: This was a remarkable finding that caught me by surprise. It should be clear that maintenance iv iron treatment would decrease the cost of EPO therapy based on the several randomized clinical trials that have examined this issue. The decrease in iron dosing and cost were very interesting. It appears that administering small regular dose of iron eliminates the need to treat patients with high dose and high cost courses of iv iron (ie 100 mg X 10). This should stimulate interest in creating a new iron dextran package containing 25 mg instead of the current 100 mg. (Stephen Fishbane, M.D., Winthrop University Hospital, Mineola, NY)
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ASN 30th Annual Meeting, San Antonio
CRF by problem area : Anemia/Erythropoietin/Iron
CRF: Problem Areas : Cost effectiveness