Kidney Week

Abstract: TH-PO349

Hyperkalemia-Related Health Care Resource Use (HRU) Associated with Short-Term vs. Long-Term Sodium Zirconium Cyclosilicate (SZC) Therapy in Patients with ESKD: The GALVANIZE Outcomes Study

Session Information

• Sodium, Potassium, and Volume Disorders: Clinical
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Fluid, Electrolytes, and Acid-Base Disorders

• 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

• Malhotra, Arun, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Arun Malhotra, MD

• Agiro, Abiy, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Abiy Agiro

• Cook, Erin, Analysis Group Inc, Boston, Massachusetts, United States

Erin Cook, PhD, MPH

• Mu, Fan, Analysis Group Inc, Boston, Massachusetts, United States

Fan Mu

• Greatsinger, Alexandra, Analysis Group Inc, Boston, Massachusetts, United States

Alexandra Greatsinger, MPH

• Chen, Jingyi, Analysis Group Inc, Boston, Massachusetts, United States

Jingyi Chen, MS, MSc

• Sundar, Manasvi, Analysis Group Inc, Boston, Massachusetts, United States

Manasvi Sundar, MPH

• Colman, Ellen, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Ellen Colman, PharmD

• Kumar, Neela, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Neela Kumar, PhD

• Rhee, Connie, University of California Los Angeles, Los Angeles, California, United States

Connie Rhee, MD, MS

Background

Long-term sodium zirconium cyclosilicate (SZC) therapy use has been shown to be associated with lower rates of hyperkalemia (HK)-related healthcare resource use (HRU) than short-term SZC therapy. However, this association has not been evaluated in patients with end-stage kidney disease (ESKD). The GALVANIZE Outcome real-world study compared HRU between long-term and short-term SZC users in patients with ESKD.

Methods

Adults with a diagnosis of ESKD initiating SZC in the outpatient setting from 7/2018-12/2022 were identified from a large US insurance claims database. Patients with long-term SZC use (>90 days) were exactly and propensity score matched on key baseline characteristics to patients with short-term SZC use (≤30 days). Rates of HK-related hospitalizations and/or emergency department (ED) visits, HK-related hospitalizations, and HK-related ED visits after SZC initiation were compared using generalized estimating equations (also done for all-cause).

Results

Of 1,010 matched pairs with ESKD, 60% were male, the mean age was 57 years. Insurance coverage included 41% of patients with Medicare Advantage, 26% with Medicaid, and 31% with commercial insurance. Hypertension (86%) and diabetes (67%) were the most common comorbidities. Patients with long-term SZC use had a 34% lower rate of HK-related hospitalizations or ED visits (p<0.001), a 34% lower rate of HK-related hospitalizations (p<0.001), and a 34% lower rate of HK-related ED visits (p<0.05) than patients with short-term SZC use.

Conclusion

Long-term SZC use among patients with ESKD was associated with significantly lower rates of HK-related HRU compared to short-term SZC use.

Figure 1. Rates of HK-related HRU for short-term vs. long-term SZC use in patients with ESKD

Funding

• Commercial Support – AstraZeneca