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  • Acknowledgment Form (acknowledgment Form) - Esa Apprise ...

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ESA APPRISE Oncology Program Patient and Healthcare Professional (HCP) Acknowledgment Form (Acknowledgment Form) For the use of erythropoiesis stimulating agents (ESAs*) ( alfa), ( alfa), or ( alfa).

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Iron deficiency, the most common cause of ESA hyporesponsiveness, can be absolute or functional.

Using ESAs to target a hemoglobin level of greater than 11 g/dL increases the risk of serious adverse cardiovascular events and has not been shown to provide additional patient benefit.

These risks include: ESAs may cause tumors to grow faster. ESAs may cause some patients to die sooner. ESAs may cause some patients to develop blood clots, and serious heart problems such as a heart attack, heart failure or stroke.

The warning states: Avoid serious cardiovascular and arterial and venous thromboembolic events by using the lowest dose of , , or that will gradually raise the hemoglobin concentration to the lowest level sufficient to avoid the need for blood transfusion.

Erythropoietin stimulating agents (ESAs) are recombinant versions of EPO produced pharmacologically. Examples of ESAs are , , and methoxy polyethylene glycol- beta.

ESAs are used to treat anemia caused by chronic kidney failure, some anticancer drugs, and certain treatments for HIV. They may also be used to lower the number of blood transfusions needed during and after certain major surgeries. Examples of ESAs are alfa (, ) and alfa ().

WARNING: ESAs INCREASE THE RISK OF DEATH, MYOCARDIAL INFARCTION, STROKE, VENOUS THROMBOEMBOLISM, THROMBOSIS OF VASCULAR ACCESS AND TUMOR PROGRESSION OR RECURRENCE.

ESA APPRISE was a risk evaluation and mitigation strategy (REMS) program created to ensure that the benefits outweighed the risks when ESAs are used to minimize red blood cell transfusions in patients with cancer and chemotherapy-induced anemia.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232