Continuous erythropoiesis receptor activator (CERA): An erythropoiesis-stimulating agent for the treatment of anemia in patients with chronic kidney disease
Chronic kidney disease (CKD) affects 20 million Americans, and an additional 20 million are at increased risk for developing CKD. Anemia is a common complication in patients with CKD. Continuous erythropoiesis receptor activator (CERA) is a new erythropoiesis-stimulating agent (ESA) that is undergoing FDA review for the treatment of anemia in patients with CKD, including in those undergoing dialysis.
Key Points
Dr O'Mara is a clinical pharmacist at Dialysis Clinics, Inc, North Brunswick, NJ. Dr Kapoian is assistant professor of medicine, University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School, New Brunswick, NJ.
Disclosure Information: The authors report no financial disclosures as related to products discussed in this article.
• Abstract
Anemia (defined by the National Kidney Foundation as a hemoglobin concentration <12 g/dL in women and <13.5 g/dL in men) is a common complication in patients with CKD.1 The primary cause of anemia in this population is a deficiency in erythropoietin. Approximately 90% of erythropoietin is produced in the kidneys, and the remainder is produced in the liver. In patients with normal renal function, erythropoietin concentrations can increase up to 100-to 1,000-fold during hypoxia or anemia. However, in patients with impaired renal function, the kidneys are unable to respond with the appropriate physiologic increase in erythropoietin concentration. In addition to erythropoietin deficiency, other factors may contribute to anemia in patients with CKD, including a shortened red blood cell survival time (from approximately 120 days in patients with normal renal function to 40–90 days in patients with impaired renal function); iron and vitamin deficiencies; and blood loss, especially in patients who are undergoing hemodialysis.2
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
