Three Nephrology TreatmentTrends Publications from BioTrends Provide a Comprehensive View of Bone and Mineral Metabolism Practice Patterns Around the Globe

EXTON, Pa., Jan. 7 /PRNewswire/ -- BioTrends Research Group, Inc. recently released its TreatmentTrends®: US Nephrology, EU Nephrology, and Canadian Nephrology publications. Each syndicated report offers comprehensive insight into the management of bone and mineral metabolism. The reports, similar to parallel BioTrends' publications on the renal anemia market, are based on responses to online surveys completed by over 300 Nephrologists in the US, over 200 Nephrologists in Europe (UK, France, Germany, Italy and Spain) and 40 Nephrologists in Canada during November / December 2009.

Treatment prevalence with phosphate binders in dialysis is similar globally with just under 90% of hemodialysis (HD) patients on binders. Treatment prevalence is lower in chronic kidney disease - non dialysis (CKD-ND) patients with more regional variation. Nephrologists around the globe agree that phosphorus is difficult to control in dialysis patients and that the need for new therapies to treat hyperphosphatemia is high. There is some variation by region, however, in terms of the phosphate binder attributes that are most important as well as ratings for how currently available products perform. There is also variation by region in terms of which binders are currently used to control phosphorus. In Canada, Italy and Spain, calcium based binders are used more often than non-calcium based binders in both dialysis and CKD-ND. In other markets, while calcium based binders are used more often in CKD-ND patients, dialysis patients tend to be on non-calcium based binders. In terms of non-calcium based binders, use of Genzyme's Renagel/Renvela vs. Shire's Fosrenol differs by region. Fosrenol had the strongest performance in France, however sevelamer (Renagel/Renvela) has a market share advantage over Fosrenol in every region. Fosrenol is expected to see share gains in the near future and the sevelamer franchise is also expected to increase as Renvela becomes more widely available in the EU markets. In the US market, the conversion from Renagel to Renvela has already been quite strong with over 90% of Nephrologists now prescribing the product and sevelamer share division favoring Renvela over Renagel.

In the PTH modifier market, there are a number of regional variations. The availability and use of active vitamin D brands, for example, differs, with Abbott's Zemplar holding the market leader position among hemodialysis patients in the US and Spain, whereas in Canada calcitriol holds the market leader position in both dialysis and CKD-ND. Alfacalcidiol leads the market in the UK, whereas in Germany, calcitriol and alfacalcidiol almost evenly divide the market. There are also differences by region in terms of when active vitamin D should be used - only when PTH is elevated or in low doses, regardless of PTH. There are however, some market similarities. In both the US and Europe, the use of nutritional vitamin D is projected to increase. In all markets, use of Amgen's Sensipar / Mimpara tends to be limited to dialysis patients. Use of Sensipar / Mimpara is, however, higher in the US than in Europe overall, but use in the US has been relatively flat while use in Europe has been growing. There are significant differences though in uptake of the product within Europe from a low of 9% market share in the UK to more than one-third of patients on the product in Spain. It will be interesting to see the bone and mineral metabolism market continue to evolve, particularly with the release of the KDIGO CKD-MBD guideline, which a number of Nephrologists believe will positively impact their use of phosphate binders, active vitamin D and cinacalcet.

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