Emerging therapies for the management of chronic hyperkalemia in the ambulatory care setting
| Autor: | Erenie Guirguis, Yasmin Grace, Amy Henneman, Dimple Patel, Bhoomi Shah |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Hyperkalemia Polymers 030204 cardiovascular system & hematology urologic and male genital diseases 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Ambulatory care Ambulatory Care medicine Animals Humans 030212 general & internal medicine Intensive care medicine Adverse effect Pharmacology Clinical Trials as Topic Aldosterone business.industry Silicates Health Policy Disease Management Patiromer medicine.disease Clinical trial chemistry Heart failure Chronic Disease Potassium medicine.symptom business Kidney disease |
| Zdroj: | American Journal of Health-System Pharmacy. 73:33-44 |
| ISSN: | 1535-2900 1079-2082 |
| DOI: | 10.2146/ajhp150457 |
| Popis: | Purpose Emerging treatment options for the management of chronic hyperkalemia in the outpatient setting are reviewed. Summary Current treatment options for the management of hyperkalemia are limited and often accompanied by serious adverse effects. Two investigational drugs for the treatment of hyperkalemia are being evaluated in Phase III trials: sodium zirconium cyclosilicate and patiromer. Both of these drugs are administered orally and act by enhancing potassium’s removal, predominantly through the gastrointestinal tract. The safety and efficacy of sodium zirconium cyclosilicate and patiromer were evaluated in Phase II and III trials. Both agents were studied in patients with chronic mild-to-severe hyperkalemia, chronic kidney disease (CKD), or heart failure as well as those taking a renin–angiotensin system (RAS) inhibitor, an aldosterone antagonist, or both therapies. These clinical trials found that sodium zirconium cyclosilicate and patiromer normalized serum potassium levels quickly and maintained normalized serum potassium levels over several weeks. Both medications caused a rapid decrease in serum potassium, with two studies examining efficacy endpoints for 12 weeks or longer. The overall frequency of adverse effects in these clinical trials was low, with gastrointestinal adverse events being the most commonly observed. Conclusion Options for the management of hyperkalemia, particularly chronic hyperkalemia in the outpatient setting, are limited. Both sodium zirconium cyclosilicate and patiromer are emerging therapies that may provide long-term management of hyperkalemia, particularly in patients with underlying heart failure or CKD as well as those taking an RAS inhibitor, an aldosterone antagonist, or both. |
| Databáze: | OpenAIRE |
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