Two Agents Show Promise for Hyperkalemia
(HealthDay News) — For patients with hyperkalemia, sodium zirconium cyclosilicate (ZS-9) and patiromer show promise for reducing potassium levels, according to two studies published online November 21 in the New England Journal of Medicine.
David K. Packham, MB, BS, MD, from the Royal Melbourne Hospital in Australia, and colleagues randomized 753 patients with hyperkalemia to receive ZS-9 or placebo for 48 hours. The researchers found that the mean reductions for patients receiving 2.5g, 5g, and 10g ZS-9 were 0.5, 0.5, and 0.7mmol/L, respectively (P<0.001 for all comparisons with placebo). Serum potassium levels were maintained at 4.7 and 4.5mmol/L during days 3–15 for those who received 5g and 10g of ZS-9, respectively, compared with a level of >5.0mmol/L for the placebo group (all comparisons, P<0.01).
Matthew R. Weir, MD, from the University of Maryland School of Medicine in Baltimore, and colleagues assessed the safety and efficacy of patiromer among patients with chronic kidney disease. The researchers found that the mean change in the serum potassium level was −1.01 ± 0.03mmol/L (P<0.001) among 237 patients receiving patiromer. Seventy-six percent of patients had reached the target potassium level at week four. In a randomized withdrawal phase, hyperkalemia recurrence occurred in 60% of patients in the placebo group vs. 15% in the patiromer group (P<0.001).
"Both agents appear to offer some promise for the treatment of hyperkalemia in patients with chronic kidney and cardiac disease," write the authors of an accompanying editorial.
The Packham study was funded by ZS Pharma, the manufacturer of ZS-9; the Weir study was funded by Relypsa, the manufacturer of patiromer.