Abstract
CHARACTERIZING SODIUM THIOSULFATE TREATMENT PATTERNS Tracy J. Mayne, Tasos Constantin, Carey Colson, Mahesh Krishnan; DaVita Inc., Denver, CO In the past 6 years, sodium thiosulfate (STS) is becoming an increasingly common off-label treatment for calciphylaxis in end-stage renal disease. Despite this, there is a paucity of data on physician prescribing patterns and patient characteristics. The goal of this analysis was to characterize patients receiving STS and how physicians prescribe this medication. We conducted a retrospective analysis of 203 hemodialysis patients treated with STS between 01/01/09 and 12/31/09 at a large U.S. dialysis organization (LDO). Patient demographics were compared to the population of 150k patients during this same period. Dosing intervals were characterized by number of doses and timing between doses. Compared to the general dialysis population, patients receiving STS were disproportionately young (mean age = 58.2±12.8), obese (mean BMI=30.9±9.3); white (53.2%); female (75.9%) from the south (39%), and long term dialysis survivors (10% > 10 yr). Censoring occurred in 67 (30%) of patients: 50 (23%) died, 16 (7%) stopped being treated at an LDO clinic, and 1 (<1%) received a kidney transplant. An additional 21 patients died and 4 were transplanted from 1/1 to 5/31/10. The majority of patients (86%) received < 3 months of STS therapy (usually 1 STS dose/session) over the course of the year: 47% 1 month, 21% 2 month, 18% 3 month. Among patients who completed a 1-month course of therapy, 11% initiated a second course within 2 weeks, 27% within 3-4 weeks; and an additional 35% within 2 months. Patients prescribed STS differ significantly from the general dialysis population. Although the majority of patients receive ≤ 12 weeks of STS therapy, duration of treatment remains highly variable. A small percentage of patients receive longer term dosing at longer intervals. Censoring occurred at rates consistent with the general population.
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