Abstract: PUB286
Daily Medication Volume of Phosphate Binder Therapies
Session Information
Category: Pharmacology (PharmacoKinetics‚ -Dynamics‚ -Genomics)
- 1900 Pharmacology (PharmacoKinetics‚ -Dynamics‚ -Genomics)
Authors
- Mistry, Nupur Sanghavi, The University of Chicago Medicine, Chicago, Illinois, United States
- Khambati, Nadia, NorthShore University Health System, Evanston, Illinois, United States
- Gupta, Pramod, Unicycive Therapeutics, Inc., Los Altos, California, United States
- Vayalakkada, Suresh, Unicycive Therapeutics, Inc., Los Altos, California, United States
- Sprague, Stuart Michael, The University of Chicago Medicine, Chicago, Illinois, United States
Background
Elevated phosphate concentrations are associated with a significantly increased risk of cardiovascular events and mortality in patients with chronic kidney disease. The current KDIGO guideline recommends lowering elevated serum phosphorus concentrations toward normal range in patients with ESKD on dialysis through restriction of dietary phosphorus intake, increase in clearance by dialysis, and the use of phosphate binders. There is evidence that 78% of patients are not adherent to phosphate binders. This is thought to be the result of phosphate binders’ large sizes and high pill burden. A high daily medication volume creates a barrier to adherence and can negatively impact the quality of life. Thus, a phosphate binder that maintains efficacy with a lower daily medication volume could improve adherence, quality of life, and potentially clinical outcomes. This study evaluated the daily medication volume of various phosphate binders to determine the option with the lowest required daily volume.
Methods
The daily dose volumes for lanthanum dioxycarbonate (RENAZORBTM), sucroferric oxyhydroxide, calcium acetate, lanthanum carbonate, ferric citrate, and sevelamer carbonate were calculated. The volume for each binder was determined by fluid displacement method, which measures the increase of volume after placing the binder into a graduated measuring cylinder with a fixed volume of liquid. Each measurement was performed in duplicate. The mean daily dose volume was calculated by multiplying the volume per tablet by the mean number of tablets taken per day, based on literature.
Results
Lanthanum dioxycarbonate and sevelamer carbonate had the lowest and highest daily dose volume, respectively.(Fig 1) The daily dose volume for lanthanum dioxycarbonate was 3-to-4-fold lower than other phosphate binders, with a total daily volume similar to ~3.5 M&M’s.
Conclusion
Lanthanum dioxycarbonate, a novel investigational nanotechnology product, may be a welcome choice for patients to manage their hyperphosphatemia. Improved size (easily swallowed) and tolerability have the potential to increase medication adherence and phosphate control.