Combined tenapanor, sevelamer may control serum phosphate in certain patients on dialysis
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Key takeaways:
- The reduction in median baseline sevelamer use went from nine pills per day to six pills per day.
- Tenapanor in combination with sevelamer could achieve long term serum phosphate control.
PHILADELPHIA — Tenapanor in combination with sevelamer may control serum phosphate levels in patients with hyperphosphatemia on dialysis, according to data from ASN Kidney Week.
“The key objective here was to see what would happen when you added tenapanor to individuals who are already taking sevelamer to see if you could obtain control of serum phosphorus, whether to the initial target of less than 4.5 mg/dL or a slightly more relaxed target of less than 5.5 mg/dL that is used in practice these days,” Daniel E. Weiner, MD, FASN, MS, of Tufts Medical Center in Boston, told Healio.
Researchers prescribed 30 mg of tenapanor twice a day to 43 patients already prescribed sevelamer for hyperphosphatemia with serum phosphate levels of greater than 4.5 mg/dL. Researchers monitored patients for safety and efficacy with in-office visits and telephone calls for up to 18 months, according to the study abstract. Researchers decreased the sevelamer dose as long as serum phosphate levels were controlled after starting tenapanor, with the goal of eventually decreasing or eliminating sevelamer, if possible. Researchers also adjusted the tenapanor dosage based on serum phosphate levels and tolerability.
According to the findings, 29% of patients achieved serum phosphate levels of 4.5 mg/dL or less at week 1 after the addition of tenapanor. Researchers found this achievement ranged from 35% to 54% at subsequent study visits. The reduction in median baseline sevelamer use went from nine pills per day to six pills per day at the end of the study.
“Patients do not have to remember to take a pill every time they eat. They take it once in the morning [and] once in the evening, [which] can improve adherence,” Weiner said.
He added, “[It] is important to have options to treat high serum phosphorus [in patients on dialysis. ... Tenapanor represents a new potentially valuable option that increases our flexibility in treating [patients] with hyperphosphatemia.”
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Weiner, DE, et al. FR-PO318. Presented at: ASN Kidney Week; Nov. 2-5, 2023; Philadelphia.
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