Abstract: TH-PO1065
Mineralocorticoid Receptor Antagonist (MRA) Use Patterns following Potassium Binder Initiation: Insights from the DEMONSTRATE Database
Session Information
- CKD: Therapeutic Advances
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Furuland, Hans, Uppsala Universitet, Uppsala, Sweden
- Larsson, Anders, Uppsala Universitet, Uppsala, Sweden
- Uhde, Milica, CLS Vifor, Uppsala, Sweden
- Almstedt, Matilda, CLS Vifor, Uppsala, Sweden
- Cars, Thomas, CLS Vifor, Uppsala, Sweden
- Svensson, Maria K., Uppsala Universitet, Uppsala, Sweden
Background
Hyperkalemia (HK) is a common in chronic kidney disease (CKD). Mineralocorticoid receptor antagonists (MRAs) provide significant cardiovascular and renal benefits but can exacerbate HK. HK often leads to the reduction or discontinuation of MRA therapy. This study aims to investigate the treatment pattern of MRA following initiation of treatment with potassium binders.
Methods
From the DEMONSTRATE database (six regions in mid-Sweden) patients with at least one pharmacy dispensation of first (sodium polystyrene sulfonate, SPS) or second-generation (patiromer or sodium zirconium cyclosilicate, SZC) potassium binders between 2005 and 2022 were selected, prescriptions were estimated and treatment episodes were established.
Results
2,146 and 280 patients were treated with MRA and initiated first and second-generation K+ binders.
The second-generation users tended to have a higher comorbidity profile. 26% had an overlapping comorbid profile of hypertension, heart failure, diabetes mellitus and CKD. Persistence to potassium binder treatment was higher among second generation users; median persistence was 87.5 and 112.5 days for first and second generation respectively. After 120 days 33% had discontinued MRA and after 240 days more than 50% (Figure 1).
Conclusion
MRA-treated patients had a high comorbidity profile and compared to the first-generation potassium binders, patients initiating second generation potassium binders had more comorbidities and longer K+ binder treatment duration. Overall, potassium binder users still dose reduced MRA to a large degree. Whether second generation binders lead to more persistent MRA use remains to be elucidated.
Figure 1 – Treatment pattern of MRA after initiation of potassium binder treatment
Funding
- Commercial Support – CLS Vifor