Vu K, Zhou J, Everhart A, et al. - In an attempt to gain insight into the de-adoption of erythropoiesis-stimulating agents (ESA) in anemia treatment among chronic kidney disease patients after new clinical evidence of harm and ineffectiveness (the TREAT trial) and the FDA’s revision of its safety warning, it was found that a dominant role is played by physician specialty in the prescribing decision, and that specializations with higher use of treatment (nephrologists) were more responsive to new evidence of unsafety and ineffectiveness.

• Commercial, Medicare Advantage and Medicare fee-for-service populations were examined to estimate changes in use of epoetin alfa (EPO) and darbepoetin alfa (DPO).

• During study span, a decline in DPO and EPO use was observed.

• Across insurance groups, no consistent alterations in DPO trend were seen, but a reduction in the level of DPO use was evident right after the FDA revision in all groups.

• Faster decline in EPO use trend was seen following the TREAT trial for all groups.

• Across insurance populations and types of ESA, there were no consistent differences by physician’s gender, and age.