Last week, the National Kidney Foundation proposed new anemia treatment guidelines for patients with chronic kidney disease, and ignore the latest FDA warnings. The agency last month told docs that raising red blood cell counts above 12 g/dL with Amgen’s Epogen and Aranesp increased the risk of death and cardiovascular events. Docs should use the lowest possible dose needed to eliminate blood transfusions, and cease therapy if a patient reaches a 12 g/dL hemoglobin count.

However, the Integrity in Science Watch team notes that the NKF’s anemia working group recommends only that docs not go above 13 g/dL while aiming for hemoglobin target “generally in the range of 11 to 12 g/dL.” Daniel Coyne, professor of medicine at Washington University in St. Louis says this is wrong: “By saying use 12 as a target, it leaves half the population at any given time above 12 because there’s a lot of variation.”

Moreover, nine of 16 docs on the NKF anemia working group have financial ties to Amgen, the Integrity project reports. One of its two co-chairs is a part-time employee of DaVita, the nation’s second largest dialysis chain. Dialysis clinic revenues and profits rise when Epogen use increases. Coyne also consults for Amgen and other producers of anti-anemia drugs.

And last month, the Renal Physicians Association urged its members to be cautious about the same FDA warning. The non-profit, which receives funding from Amgen, J&J and other drugmakers, released a statement calling the advisory potentially “misleading” and says that some of FDA recommendations ‘only partly’ apply to chronic patients. The group is encouraging doctors to make treatment decisions on a case-by-case basis.

Professional groups may not think so or care, but they lack credibility when their members issue recommendations that can affect their individual financial circumstances. There are plenty of qualified nephrologists out there. Find a few who aren’t connected to Amgen.

Source: Center for Science in the Public Interest.
Further reading…
National Kidney Foundation statement.
National Kidney Foundation guidelines.
The FDA statement;
FDA warning;
Letter from the Renal Physicians Association.
[tags]Amgen, National Kidney Foundation, Renal Physicians Association[/tags]