title: Biosimilar ESAs: a comparative review.
abstract: BACKGROUND
  The management of anaemia in patients with chronic kidney disease has been transformed by development of erythropoiesis-stimulating agents (ESAs). Following expiry of the patent of the originator epoetin alfa in Europe, a number of biosimilar ESAs have been licensed for use in the nephrology setting. Biosimilars are biological medicines that are approved via stringently defined regulatory pathways on the basis that they have demonstrated comparable safety, efficacy and quality to their reference product.
  
  
  OBJECTIVE
  As nurses have a pivotal role in patient care, not only administering medications but also educating patients about their treatment options, it is important that nurses understand the differences between biosimilar medicines and their reference products and appreciate the stringent regulatory requirements for approval of biosimilars.
  
  
  METHODS
  In this review, we use epoetin zeta as a case study to highlight practical considerations of using biosimilar ESAs in the management of patients with kidney disease.
  
  
  CONCLUSIONS
  Biosimilar products, such as epoetin zeta, may offer a range of features to patients, nurses and physicians, such as greater flexibility over dose and route of administration, in addition to greater access to biological medicines through cost savings.
  
  
  CONCLUSIONS
  Renal nurses play a significant role in the management of patients with kidney disease and anaemia, not only having an important role in the delivery of medicine but also in the education of patients. This review discusses some of the practical aspects associated with the use of biosimilar medicines to assist nurses in making informed decisions over their use.
authors.affiliation: Darent Valley Hospital, Darenth Wood Road, Dartford, Kent, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Wilson
authors.forename: Cheryl
authors.initials: C
authors.lastname: Wood
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000451:nursing*; D059451:Biosimilar Pharmaceuticals / Q000627:therapeutic use*; D004921:Erythropoietin / Q000627:therapeutic use; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy* / Q000451:nursing*; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D059451:Biosimilar Pharmaceuticals; D006397:Hematinics; D011994:Recombinant Proteins; C530192:epoetin zeta; D004921:Erythropoietin
keywords: Anaemia; Biosimilar; Chronic kidney disease; Epoetin