Lanthanum carbonate versus standard therapy for the treatment of hyperphosphatemia: safety and efficacy in chronic maintenance hemodialysis patients

Finn, William F.

doi:10.5414/cnp65191

Cited by 118 publications

(93 citation statements)

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“…Also, ferric citrate had a lower average pill burden compared with sevelamer carbonate, with comparable phosphorus control. The few currently available phosphate binders have limitations, including aluminum toxicity, 12 diarrhea, [13][14][15][16][17] hypercalcemia, 14 and patient tolerability issues. [14][15][16][17][18] There were more discontinuations for all causes, including renal transplantation, in the ferric citrate versus active control groups (33% ferric citrate versus 23% active control).…”

Section: Discussionmentioning

confidence: 99%

Ferric Citrate Controls Phosphorus and Delivers Iron in Patients on Dialysis

Lewis

Sika

Koury

et al. 2015

Journal of the American Society of Nephrology

168

207

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Patients on dialysis require phosphorus binders to prevent hyperphosphatemia and are iron deficient. We studied ferric citrate as a phosphorus binder and iron source. In this sequential, randomized trial, 441 subjects on dialysis were randomized to ferric citrate or active control in a 52-week active control period followed by a 4-week placebo control period, in which subjects on ferric citrate who completed the active control period were rerandomized to ferric citrate or placebo. The primary analysis compared the mean change in phosphorus between ferric citrate and placebo during the placebo control period. A sequential gatekeeping strategy controlled study-wise type 1 error for serum ferritin, transferrin saturation, and intravenous iron and erythropoietin-stimulating agent usage as prespecified secondary outcomes in the active control period. Ferric citrate controlled phosphorus compared with placebo, with a mean treatment difference of 22.260.2 mg/dl (mean6SEM) (P,0.001). Active control period phosphorus was similar between ferric citrate and active control, with comparable safety profiles. Subjects on ferric citrate achieved higher mean iron parameters (ferritin=8996488 ng/ml [mean6SD]; transferrin saturation=39%617%) versus subjects on active control (ferritin=6286367 ng/ml [mean6SD]; transferrin saturation=30%612%; P,0.001 for both). Subjects on ferric citrate received less intravenous elemental iron (median=12.95 mg/wk ferric citrate; 26.88 mg/wk active control; P,0.001) and less erythropoietin-stimulating agent (median epoetin-equivalent units per week: 5306 units/wk ferric citrate; 6951 units/wk active control; P=0.04). Hemoglobin levels were statistically higher on ferric citrate. Thus, ferric citrate is an efficacious and safe phosphate binder that increases iron stores and reduces intravenous iron and erythropoietin-stimulating agent use while maintaining hemoglobin.

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Section: Discussionmentioning

confidence: 99%

Ferric Citrate Controls Phosphorus and Delivers Iron in Patients on Dialysis

Lewis

Sika

Koury

et al. 2015

Journal of the American Society of Nephrology

168

207

View full text Add to dashboard Cite

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“…Extensive clinical data support its efficacy and tolerability in both short-term (6,7) and long-term (8,9) treatment of hyperphosphatemia in patients with stage 5 CKD. Reformulated (500 mg) and higher strength (750 and 1000 mg) lanthanum carbonate tablets have been available since 2006.…”

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confidence: 99%

Higher Strength Lanthanum Carbonate Provides Serum Phosphorus Control With a Low Tablet Burden and Is Preferred by Patients and Physicians

Mehrotra

Martin

Fishbane

et al. 2008

Clinical Journal of the American Society of Nephrology

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Results: At the end of week 4, 54% of patients achieved serum phosphorus control at dosages <3000 mg/d administered as one tablet per meal. Among patients who entered cohort B, control rates of 25, 38, and 32% for patients who were randomly assigned to 3000, 3750, or 4500 mg/d lanthanum carbonate, respectively, were achieved, with no increase in adverse events. Patients and physicians reported significantly higher levels of satisfaction with reformulated lanthanum carbonate compared with previous phosphate binders, partly because of reduced tablet burden with higher dosage strengths. Physicians and patients also expressed a preference for lanthanum carbonate over previous medication.Conclusions: Reformulated lanthanum carbonate is an effective phosphate binder that may reduce daily tablet burden.

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“…Both short-and long-term clinical studies have demonstrated efficacy and an acceptable safety profile (15)(16)(17)(18). This study was designed to evaluate the efficacy and safety of lanthanum carbonate for use in patients with CKD stages 3 and 4, a population in which randomized, controlled clinical trials of phosphate binders are sparse (19).…”

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confidence: 99%