Using iron-based phosphate binders in phosphate reduction and anemia improvement in patients receiving dialysis: a meta-analysis of randomized controlled trials

Zhu, Yan; Rao, Jinlan; Liao, Xueling; Ou, Jihong; Li, Wei; Xue, Chao

doi:10.1007/s11255-021-02820-y

Cited by 4 publications

(5 citation statements)

References 34 publications

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“…13 Consistently, studies have found that long-term use of SO is not complicated by significant risk of iron overload. 13,[18][19][20] We did not find a change in dose of erythropoietin use in the long term. While there was a trend towards lower use of anti-anaemic products (erythropoiesis-stimulating agents and intravenous iron) among patients treated with SO compared with those treated with sevelamer carbonate in the phase III study and its extension, 18 other studies have shown that SO use did not change haematological parameters, use of iron supplementation or erythropoietin dose.…”

Section: Discussioncontrasting

confidence: 51%

“…13 Consistently, studies have found that long-term use of SO is not complicated by significant risk of iron overload. 13,18–20…”

Section: Discussionmentioning

confidence: 99%

“…While there was a trend towards lower use of anti-anaemic products (erythropoiesis-stimulating agents and intravenous iron) among patients treated with SO compared with those treated with sevelamer carbonate in the phase III study and its extension, 18 other studies have shown that SO use did not change haematological parameters, use of iron supplementation or erythropoietin dose. 19,20…”

Section: Discussionmentioning

confidence: 99%

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Sucroferric oxyhydroxide use in patients on haemodialysis – real-world experience from an Asian cohort

Teo,

Ng,

See

et al. 2023

Proceedings of Singapore Healthcare

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Background Sucroferric oxyhydroxide has been used in the treatment of hyperphosphataemia in adult patients with chronic kidney disease receiving haemodialysis or peritoneal dialysis since 2013. However, there is a paucity of data on sucroferric oxyhydroxide use in Asian populations. Objective We aim to provide real-world experience of sucroferric oxyhydroxide use in our local cohort on maintenance haemodialysis. Methods A retrospective clinical audit was performed to review laboratory parameters of haemodialysis patients who received sucroferric oxyhydroxide over a 14-month period from December 2020 to January 2022. Sucroferric oxyhydroxide reduced serum phosphate levels effectively, with a more than 3-fold increase in the proportion of patients who were able to achieve phosphate levels of ≤5.5 mg/dL. Ferritin levels and transferrin saturation were increased, but there were no significant differences in haemoglobin levels and erythropoietin used in the long term. We showed that sucroferric oxyhydroxide was highly effective in reducing serum phosphate to recommended levels in patients receiving haemodialysis. Further prospective studies in Asian populations are warranted to confirm our findings.

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Section: Discussioncontrasting

confidence: 51%

“…13 Consistently, studies have found that long-term use of SO is not complicated by significant risk of iron overload. 13,18–20…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sucroferric oxyhydroxide use in patients on haemodialysis – real-world experience from an Asian cohort

Teo,

Ng,

See

et al. 2023

Proceedings of Singapore Healthcare

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“…Compared to placebo, the serum phosphate concentration was significantly reduced after the use of ferric citrate, the haemoglobin concentration increased significantly, and the parameters of iron metabolism improved, while sucroferric oxyhydroxide had no effect on the serum haemoglobin concentration. It has also been noted that iron citrate and sucroferric oxyhydroxide decrease serum PTH levels [22]. Other phosphate binders have also been studied in recent years, such as colestilan (a non-absorbable resin that binds phosphate and bile acids in the intestine).…”

Section: Medications Lowering Serum Phosphate Levelmentioning

confidence: 99%

Secondary hyperparathyroidism in chronic kidney disease: pathomechanism and current treatment possibilities

Rodzoń-Norwicz,

Norwicz,

Sowa-Kućma

et al. 2023

Endokrynol Pol

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circle. It should be emphasized here that the results of recent studies indicate that fibroblast growth factor 23 (FGF-23) and Klotho protein are the factors whose concentrations changes appear the earliest in the development of SHPT.The main and most dangerous complications of SHPT involve the skeletal and cardiovascular systems. Calcium and phosphate imbalances associated with CKD are defined by the Kidney Disease Improvement Global Outcomes (KDIGO) group as chronic kidney disease-metabolic bone disease (CKD-MBD). CKD-MBD includes bone complications that can lead to chronic pain syndromes and mobility limitations, cardiovascular complications, significantly increasing mortality in this group of patients, and soft tissue calcifications [1,2,3]. The last guidelines for the treatment of SHPT in the course of CKD were published by KDIGO in 2017 and have not been updated. This manuscript is a review of the literature published mainly after 2017, paying special attention to potentially new therapies that seem to be promising in the treatment of SHPT.

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“…Ferric citrate, a well-developed phosphorus binder, has been approved in the USA, Japan, the European Union, and Taiwan [20, 21]. It reacts with dietary phosphorus in the gastrointestinal tract to form the insoluble ferric phosphate precipitate, a process that reduces phosphate absorption from the gastrointestinal tract and thus lowers serum phosphorus levels.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Ferric Citrate on Hyperphosphatemia among Chinese Patients with Chronic Kidney Disease Undergoing Hemodialysis: A Phase III Multicenter Randomized Open-Label Active-Drug-Controlled Study

Wang,

Chen,

Zhu

et al. 2023

Am J Nephrol

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Background: Hyperphosphatemia in CKD patients is positively associated with mortality. Ferric citrate is a potent phosphorus binder that lowers serum phosphorus level and improves iron metabolism. We compared its efficacy and safety with active drugs in Chinese CKD patients with hemodialysis. Trial design: This is an open-label active-drug-controlled multicenter randomized study. Methods: Chinese patients undergoing hemodialysis were randomized into two treatment groups in a 1:1 ratio receiving either ferric citrate or sevelamer carbonate respectively for 12 weeks. Serum phosphorus levels, calcium concentration, and iron metabolism parameters were evaluated at every two weeks. Frequency and severity of adverse events were recorded. Results: 217 (90.4%) patients completed the study, with balanced demographic and baseline characteristics between two groups. Ferric citrate decreased the serum phosphorus level to 0.59±0.54mmol/L, comparable to 0.56 ± 0.62 mmol/L by sevelamer carbonate. There was no significant difference between two groups (P>0.05) in the proportion of patients with serum phosphorus levels reaching the target range, the response rate to the study drug, and the changes of corrected serum calcium concentrations, and intact-PTH levels at the end of treatment. The change of iron metabolism indicators in the ferric citrate group were significantly higher than those in the sevelamer carbonate group. There are 47 (40.5%) patients in the ferric citrate group, and 26 (21.3%) in the sevelamer carbonate group experienced drug-related TEAEs, most were mild and tolerable. Common drug-related TEAEs were "gastrointestinal disorders", including diarrhea (12.9% vs. 2.5%), feacal discoloration (14.7% vs. 0%), and constipation (1.7% vs. 7.4%) in ferric citrate and sevelamer carbonate group respectively. Conclusion: Ferric citrate capsules have good efficacy and safety in the control of hyperphosphatemia in adult patients with CKD undergoing hemodialysis. Efficacy is not inferior to sevelamer carbonate. The TEAEs were mostly mild and tolerated by the patients.

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Using iron-based phosphate binders in phosphate reduction and anemia improvement in patients receiving dialysis: a meta-analysis of randomized controlled trials

Cited by 4 publications

References 34 publications

Sucroferric oxyhydroxide use in patients on haemodialysis – real-world experience from an Asian cohort

Sucroferric oxyhydroxide use in patients on haemodialysis – real-world experience from an Asian cohort

Secondary hyperparathyroidism in chronic kidney disease: pathomechanism and current treatment possibilities

Efficacy and Safety of Ferric Citrate on Hyperphosphatemia among Chinese Patients with Chronic Kidney Disease Undergoing Hemodialysis: A Phase III Multicenter Randomized Open-Label Active-Drug-Controlled Study

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