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Study: No difference in cardiac risk among patients using lanthanum carbonate, calcium carbonate
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SAN DIEGO —Patients on hemodialysis who have a high risk of vascular calcification show no difference in cardiovascular risk if they receive the non-calcium binder lanthanum carbonate or the calcium carbonate binder, according to data presented at ASN Kidney Week. The results were part of the multicenter LANDMARK study, a randomized, open-label trial comparing the effects of lanthanum carbonate with the effects of calcium carbonate.
“The non-Ca P binder, lanthanum carbonate, did not reduce [cardiovascular events] CVEs as compared with calcium carbonate among long-term HD patients with high risk of vascular calcification,” Hiroaki Ogata, MD, said in his presentation here.
Ogata and colleagues from Japan reported that the study included 2,309 patients in 273 dialysis facilities who were tracked from November 2011 to June 2014. Each patient had at least one risk factor for vascular calcification. Patients were randomly assigned to the two groups.
In the lanthanum carbonate group, patients initially received 750 mg/day of the drug and were titrated up to a maximum of 2,250 mg/day to achieve serum phosphorus levels of 3.5 to 6.0 mg/dL. In the calcium carbonate group, patients received 3 g per day of the drug and were titrated to reach the same levels. The primary endpoint for the patients in the two groups was survival time free of cardiovascular events, including cardiovascular death, nonfatal myocardial infarction or stroke and unstable angina.
After a median follow-up of 3.16 years, the incident rates of cardiovascular events were 4.8 in the lanthanum carbonate group and 4.3 in the calcium carbonate group. – by Mark E. Neumann
Reference: Ogata H, et al. Abstract #FR-OR146. Presented at ASN Kidney Week; Oct. 23-28, 2018; San Diego.
Disclosure: Ogata reports the study was funded by Bayer Yakuhin Ltd.