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Journal of Pharmacy Practice
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A Comparative Review of Erythropoiesis Stimulating Agents

Nicole L. Metzger, PharmD

Department of Pharmacy Practice, Mercer University College of Pharmacy and Health Sciences, Atlanta, Georgia, METZGER_NL{at}mercer.edu

Kerry E. Francis, PharmD

Department of Pharmacy Services, Virginia Commonwealth University Health System, Medical College of Virginia Campus, Richmond, Virginia

Stacy A. Voils, PharmD, BCPS

Department of Pharmacy Services, Virginia Commonwealth University Health System, Medical College of Virginia Campus, Richmond, Virginia

Erythropoiesis stimulating agents have been used for more than a decade in patients with chronic kidney disease, malignancy, and other disease states where anemia is common. Recently, several clinical trials have questioned the safety and efficacy of these agents. Thrombosis and increase in tumor progression as well as a potential increase in mortality have been noted in some trials and have generated growing concern regarding whether these agents should remain on the US market. Subsequently, reimbursement from some payers for erythropoiesis stimulating agent administration has become somewhat restrictive. We address the pharmacology, pharmacokinetics, pharmacodynamics, safety, efficacy, and pharmacoeconomics of erythropoiesis stimulating agents as well as emerging regulatory issues pertaining to the administration of erythropoiesis stimulating agents.

Key Words: Erythropoiesis stimulating agents • ESA • darbepoetin • epoetin • safety • cost

This version was published on December 1, 2008

Journal of Pharmacy Practice, Vol. 21, No. 6, 424-430 (2008)
DOI: 10.1177/0897190008319270
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