Patiromer lowers serum potassium, is tolerable in older patients
Click Here to Manage Email Alerts
Patients aged 75 years and older with chronic kidney disease, type 2 diabetes, hypertension and hyperkalemia had “significant reductions in serum potassium” after treatment with patiromer, according to results of a secondary analysis.
“Older people are more likely to have reduced kidney function and multiple comorbid conditions predisposing them to hyperkalemia,” George L. Bakris, MD, and colleagues wrote. “This post hoc subgroup analysis aimed to evaluate the effectiveness of patiromer, a sodium-free non-absorbed polymer, in lowering serum potassium in older patients receiving a renin-angiotensin-aldosterone system (RAAS) inhibitor with chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), and hypertension.”
The post hoc analysis of the randomized, open-label, multicenter AMETHYST-DN clinical trial used data from a subgroup of 60 patients (mean age, 77 years; men, 50%; mean serum potassium at baseline, 5.19 mEq/L). Researchers wrote that because the subgroup “was not prespecified,” their results “should be considered hypothesis generating.”
Patients in the AMETHYST-DN trial were randomly assigned to receive patiromer doses that ranged from 4.2 g to 16.8 g, according to Bakris and colleagues. Outcome measures included frequency of adverse events, clinical laboratory measurements (including serum potassium) and vital signs. Researchers assessed outcomes at week 4 and at multiple time points through week 52.
Investigators discovered mean serum potassium decreased. They found 88% to 98% of patients had serum potassium in the normal range, which researchers wrote was 3.8 mEq/L to 5 mEq/L, during the follow-up period. At week 52, all patients had serum potassium levels of less than 5.5 mEq/L and 95% had serum potassium levels of less than 5 mEq/L, data showed. Researchers wrote that the findings of the subgroup “correlate with the original AMETHYST-DN investigation.”
Researchers characterized patiromer as “generally well-tolerated” within the subgroup. Of 10 patients who reported at least one adverse event considered related to the treatment, no events were considered serious, according to researchers. The most frequent adverse event was hypomagnesmia (6.6%), according to researchers. They also wrote that no patients discontinued the study due to hypomagnesmia.
“Among older patients with hyperkalemia and diabetic kidney disease, treatment with patiromer resulted in significant reductions in serum potassium levels after 4 weeks and lasted through 52 weeks,” researchers wrote. “Patiromer was effective in lowering serum potassium and was well tolerated in older patients.”
Collapse
Read more about
Click Here to Manage Email Alerts