Medication Burden and Prescribing Patterns in Patients on Hemodialysis in the USA, 2013–2017

Paik, Julie M.; Zhuo, Min; York, Cassandra; Tsacogianis, Theodore; Kim, Seo Young; Desai, Rishi

doi:10.1159/000520028

Cited by 10 publications

(18 citation statements)

References 51 publications

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“…Table 2 shows a detailed overview of the 10 studies. Six were cross-sectional studies [ 14–16 , 19 , 21 , 22 ], one was a prospective cohort study [ 17 ], two were retrospective cohort studies [ 20 , 23 ], and one was an intervention cohort study [ 18 ]. One study was published in 2014 [ 21 ], one in 2017 [ 22 ], two in 2018 [ 14 , 15 ], one in 2019 [ 17 ], four in 2021 [ 18–20 , 23 ], and one most recently in 2023 [ 16 ].…”

Section: Resultsmentioning

confidence: 99%

“…One study was published in 2014 [ 21 ], one in 2017 [ 22 ], two in 2018 [ 14 , 15 ], one in 2019 [ 17 ], four in 2021 [ 18–20 , 23 ], and one most recently in 2023 [ 16 ]. One was from the Middle East [ 16 ], four from Asia [ 14 , 15 , 18 , 22 ], three from Europe [ 17 , 21 , 23 ], one from North America [ 20 ], and one from Australia [ 19 ]. The smallest study included 150 patients [ 18 ], and the largest study included 27,573 patients [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Medication burden in patients with dialysis-dependent CKD: a systematic review

Liu,

Chen,

Liu

et al. 2024

Renal Failure

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Medication burden in patients with dialysis-dependent CKD: a systematic review

Liu,

Chen,

Liu

et al. 2024

Renal Failure

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“…Our study may demonstrate an overall strategy to use drug alternatives which are available in intravenous forms for chronic hemodialysis patients, to help reduce polypharmacy and pill burden. Examples of these are intravenous iron preparations, activated vitamin D analogues in intravenous forms, and now a calcimimetic that is available in parenteral preparation [ 17 ]. Overall, such a broader strategy may significantly improve clinical outcomes for patients suffering from poor clinical outcomes due to non-compliance [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Real-World Experience of Using Etelcalcetide for Secondary Hyperparathyroidism in Community-Based Hemodialysis Centers in Singapore

Khan,

Qu,

Hua

et al. 2023

Cureus

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Introduction Chronic kidney disease-related mineral and bone disorder (CKD-MBD), characterized by abnormalities in calcium, phosphate, and parathyroid hormone metabolism, with impaired bone turnover and extravascular calcification is a known complication of advanced chronic kidney disease (CKD). Secondary hyperparathyroidism (SHPT) develops early in the disease and its prevalence gradually increases with the disease progression, becoming almost universal in patients with end-stage renal disease (ESRD). The treatment for SHPT includes synthetic vitamin D analogs, calcitriol or calcimimetics. Recently, intravenous etelcalcetide was introduced as a second-generation calcimimetic. This article provides the real-world experience of using etelcalcetide in multiethnic Asian patients receiving hemodialysis at community-based hemodialysis centers in Singapore. Methods This study was real-world evidence, generated by a retrospective clinical audit of routine clinical care of hemodialysis patients in community-based centers in Singapore who received etelcalcetide for treating SHPT. The information on the starting and maximum dose of etelcalcetide, duration of treatment on hemodialysis, parathyroid hormone (PTH) levels, dialysate calcium, concomitant medications, and reasons for discontinuation were collected from the medical records. PTH levels were collected at four-, eight-, and twelve-month intervals. Results A total of 148 patients received etelcalcetide during the study period. Ten patients died and twenty discontinued their treatment, with 118 patients remaining on treatment. Demographically, the patients included Chinese, Malay, Indians, and those belonging to other racial groups. The starting dose of etelcalcetide ranged from 2.5 mg once per week to 7.5 mg three times a week. There was a 16.8% reduction (p=<0.001) in intact-PTH after four months of therapy. Target intact-PTH level of less than 60 pmol/L, was reported as 1.4% at baseline, with 22.3% at four months (p<0.001) and 25.9% at eight months (p=0.028). Calcium and phosphate levels were also tracked as part of the safety and efficacy measures of using etelcalcetide. No symptomatic hypocalcemia was noted and phosphate levels were noted to decline significantly. Overall, the calcium-phosphate product reduced at four months (13.2%, p=<0.001) and eight months (12.7%, p<0.05). An analysis of concomitant medication usage, dialysate calcium utilized, and the side effects of etelcalcetide were also recorded. Finally, a brief descriptive analysis of the patient's subjective feedback regarding etelcalcetide was also reported, especially regarding the reduction in pill burden and overall compliance to medications. Conclusion Etelcalcetide is safe and effective for treating SHPT in multi-ethnic Asian hemodialysis patients and can be considered an alternative to oral cinacalcet. Our study showed no side effects, which was one of the key reasons for non-compliance to traditional calcimimetics...

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“…This important study adds rich qualitative observations to an existing body of evidence that demonstrates the overwhelming complexity of a typical dialysis patient's medication regimen with a mean of 6.8 (SD 3.6) medications, 2 the challenges that clinicians face as comanagers of a regimen they only partially control, and the weighing of risks and benefits that patients undertake as they prioritize among many competing issues. 3…”

mentioning

confidence: 99%