EXTON, Pa., Oct. 27 /PRNewswire/ -- BioTrends Research Group, Inc.released two new Nephrology TreatmentTrends™ publications based on surveyresults from 204 Nephrologists and 201 Renal Dietitians in the US. RenalDietitians (RDs) are an integral part of the management of dialysis patients,particularly in their role recommending and reinforcing adherence withPhosphate Binders, Active Vitamin D, and Calcimimetic agents.
In the phosphate binder market, the introduction of Genzyme's Renvela hasgiven overall sevelamer share a boost compared to the same quarter last year,although most of the patients on Renvela have been switched from Renagel.Close to two-thirds of MDs and over three quarters of RDs have used Renvela intheir hemodialysis patients, however, Renagel and FMC's PhosLo remain the twomost frequently prescribed binders among dialysis patients. While sevelamerhas the highest share across all types of dialysis units, Shire's Fosrenoldoes its best in Davita units whereas PhosLo does its best in Fresenius units.Nephrologists are divided as to their first line preference in dialysis --approximately half choose a calcium-based binder and half choose a non-calciumbased binder compared to over two-thirds of RDs who choose to start with anon-calcium based binder. In patients with Chronic Kidney Disease not ondialysis (CKD), 73% of Nephrologists prefer to start with calcium-basedbinders.

In the PTH modifier market, although RDs report a high level of influencein the choice of Vitamin D, approximately 80% report that their dialysiscenter generally encourages the use of Abbott's Zemplar, compared to only 29%who report they are encouraged to use Genzyme's Hectorol. While Zemplar IV isthe overwhelming market share leader in hemodialysis and leads in every typeof dialysis unit, Hectorol does its best in non-chains and its worst inDavita. In CKD, Nephrologists continue to use oral calcitriol most often.Compared to the prior year, RDs report a high and growing influence indecisions regarding the use of Sensipar. Treatment prevalence with Sensiparin hemodialysis patients, according to both MDs and RDs has been lingering ataround 30%. While Sensipar is often used second line to Vitamin D, it doesseem to impact Vitamin D dose, with the majority of RDs reporting thatpatients on Sensipar tend to be on lower doses of Vitamin D.

In the renal anemia market, Nephrologists seem to be settling into the newtreatment standards (e.g., lower target hemoglobin levels, lower levels forESA initiation, holds, and dose reductions) and more than two-thirds do notanticipate making any additional changes to their use of ESAs in CKD ordialysis. While Amgen's Epogen continues to dominate the dialysis market,there did seem to be some brand shifting between Amgen's Aranesp and OrthoBiotech's Procrit in CKD. Nephrologists do not predict significant changes inESA market share in CKD or dialysis in the near-term, but they do project thatbundling will have an impact on ESA use most likely through shifts tosubcutaneous dosing and less aggressive treatment of EPO hypo-responders. NewESAs in development could also shift market dynamics particularly if theseproducts are able to meet what Nephrologists identified as the most desiredattributes in a new ESA.

In terms of IV iron, American Regent's Venofer remains the market leaderin both dialysis and CKD, however, office-based Nephrologists reportsignificantly higher CKD share for Venofer and hospital-based Nephrologistsreport significantly higher CKD share for Watson's Ferrlecit. In the dialysismarket, very little brand switching took place in the past year, although 60%of Nephrologists primarily affiliated with Fresenius units expect their use ofVenofer to increase following the news that Fresenius will be marketing anddistributing Venofer in dialysis units. Awareness of AMAG Pharmaceutical'sFerumoxytol continues to be low. Among those familiar with the product,expected benefits center around dosing and administration, particularly forCKD patients. More than half of Nephrologists believe that the introductionof this new product will lead to an overall increase in their use of IV ironin CKD.

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