Anti-Erythropoietin Antibodies and Pure Red Cell Aplasia

Rossert, Jérôme; Casadevall, Nicole; Eckardt, Kai‐Uwe

doi:10.1097/01.asn.0000107561.59698.42

Cited by 129 publications

(98 citation statements)

References 29 publications

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“…152 When due to thymoma, symptoms rarely resolve after thymectomy, and immunosuppression is usually required after surgery. 149 Erythropoietin-stimulating agents (eg, erythropoietin, darbopoietin) have been associated with the development of pure red cell aplasia 164 and are not recommended.…”

Section: Paraneoplastic Hematologic Syndromesmentioning

confidence: 99%

Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment

Pelosof

Gerber

2010

Mayo Clinic Proceedings

567

514

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Section: Paraneoplastic Hematologic Syndromesmentioning

confidence: 99%

Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment

Pelosof

Gerber

2010

Mayo Clinic Proceedings

567

514

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Section: Route Of Administration: IV Versus Scmentioning

confidence: 99%

“…However, these advantages need to be weighed against the potential downside of SC administration, including pain at injection site and the increased risk of pure red cell aplasia (PRCA) (14). Although rare (14), this potentially life-threatening condition should be considered. With these issues in mind, use of ESAs that require a similar dose whether given via the IV or the SC route (such as longeracting ESAs) (15)(16)(17) may provide an advantage in this new bundled-rate system.…”

Section: Route Of Administration: IV Versus Scmentioning

confidence: 99%

Bundled-Rate Legislation for Medicare Reimbursement for Dialysis Services

Charytan¹

2010

Clinical Journal of the American Society of Nephrology

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With the incidence of ESRD on the rise, there is a continuing need to control anemia-related treatment costs in dialysis patients receiving reimbursement through Medicare. Currently, erythropoiesis-stimulating agents (ESAs) are billed separately from dialysis services, potentially creating little financial incentive for more efficient use. The Medicare Improvement for Patients and Providers Act, passed by the U.S. Congress in July 2008, includes provisions intended to address this concern. Under this act, dialysis services will be reimbursed using a fully bundled, comprehensive payment system that includes all services currently covered in the basic composite rate, as well as certain separately billable items, including ESAs. A base rate of $229.63 per treatment has been assigned, to be individualized using case-mix adjusters. The implications of this new system for anemia management with ESAs continue to be elucidated. With fixed compensation for ESAs, management strategies that maximize efficiencies and, thereby, optimize cost savings will be favored. Select strategies may include switching from intravenous (IV) to subcutaneous routes, lowering Hb targets and ESA doses in hyporesponsive patients, increasing administration of IV iron, increasing use of home dialysis, and optimizing ESA dosing intervals. Once-monthly ESA therapy has potential advantages under this new system as an alternative to more frequently administered ESAs and may help achieve quality metrics in a cost-efficient manner.

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“…As well as searching for orally active formulations that will simplify the management of anemia [199][200][201][202] . There have also been negative aspects of treatment with EPO, as the cases of pure red cell aplasia [64,80] , or poor outcomes in relation to death and cardio vascular events in study of normalization of hemoglobin (in connection especially with high doses of EPO in patients with poor response) [127][128][129]137] and worse survival in patients with cancer [103,104] . However, EPO has been shown to be effective and safe in the treatment of anemia of chronic renal failure and has improved significantly quality of life of patients with chronic anemia [22][23][24][25] .…”

Section: Summary and Prospectsmentioning

confidence: 99%

“…Alternatively, it has been suggested that leachates released by the uncoated rubber stoppers of the pre-filled syringes may interact with polysorbate 80 and act as an adjuvant to the immune response. Failure in the cold chain is also a potential factor involved [78][79][80] . The number of cases reported has dropped significantly from 2003, with none in 2007.…”

Section: Side Effects Of Esasmentioning

confidence: 99%

Use of agents stimulating erythropoiesis in digestive diseases

López¹,

Sicilia²,

García³

2009

WJG

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Anemia is the most common complication of inflammatory bowel disease (IBD). Control and inadequate treatment leads to a worse quality of life and increased morbidity and hospitalization. Blood loss, and to a lesser extent, malabsorption of iron are the main causes of iron deficiency in IBD. There is also a variable component of anemia related to chronic inflammation. The anemia of chronic renal failure has been treated for many years with recombinant human erythropoietin (rHuEPO), which significantly improves quality of life and survival. Subsequently, rHuEPO has been used progressively in other conditions that occur with anemia of chronic processes such as cancer, rheumatoid arthritis or IBD, and anemia associated with the treatment of hepatitis C virus. Erythropoietic agents complete the range of available therapeutic options for treatment of anemia associated with IBD, which begins by treating the basis of the inflammatory disease, along with intravenous iron therapy as first choice. In cases of resistance to treatment with iron, combined therapy with erythropoietic agents aims to achieve near-normal levels of hemoglobin/hematocrit (11-12 g/dL). New formulations of intravenous iron (iron carboxymaltose) and the new generation of erythropoietic agents (darbepoetin and continuous erythropoietin receptor activator) will allow better dosing with the same efficacy and safety.

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Anti-Erythropoietin Antibodies and Pure Red Cell Aplasia

Cited by 129 publications

References 29 publications

Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment

Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment

Bundled-Rate Legislation for Medicare Reimbursement for Dialysis Services

Use of agents stimulating erythropoiesis in digestive diseases

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