Binders Unequal in Phosphorus Lowering by ProQuest


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									Renal Week_1209   11/24/09   12:21 PM    Page 2
                                                                                    DECEMBER 2009          Renal & Urology News 15

                                                                                                                                                s   Renal Week 2009, San Diego

      Binders Unequal in Phosphorus Lowering                                                                                             Binders Plus
      Lanthanum carbonate provided greater reductions in HD patients
                                                                                                                                         Vitamin D
       LANTHANUM carbonate treat-                                                                                                        Aid Survival
       ment achieved greater reductions in
       serum phosphorus than did seve-                                                                                                   A STUDY of Japanese dialysis patients
       lamer hydrochloride in a study of                                                                                                 demonstrated that a combination of
       hemodialysis (HD) patients with                                                                                                   oral vitamin D and a phosphorus binder
       elevated serum phosphorus.                                                                                                        is associated with lower mortality.
         The study enrolled 182 HD patients
                                                                                                                                           The study, by Tsuneo Konta, MD,
       with serum phosphorus levels of
                                                                                                                                         PhD, Associate Professor of
       6 mg/dL or higher and calcium levels
       of 8.4 mg/dL or higher. Investigators                                                                                             Nephrology at Yamagata University
       led by Stuart M. Sprague, DO, of                                                                                                  School of Medicine in Yamagata,
       NorthShore University HealthSystem,                                                                                               Japan, included 466 patients at
       Northwestern University, Evanston,                                                                                                17 hospitals who were on mainte-
       Ill., randomized patients to receive                                                                                              nance dialysis at the end of 2003.
       either lanthanum carbonate or seve-        The American Society of Nephrology’s Renal Week 2009 drew 12,750 attendees,            Investigators divided patients into
       lamer hydrochloride for four weeks.        including 6,511 physicians to the San Diego Convention Center.
                                                                                                                                         one of four groups. One group
       Following a two-week washout peri-
                                                                                                                                         received both oral vitamin D and a
       od, patients switched to the other         “completer” population consisting of        “These results suggest that lan-
                                                                                                                                         phosphorus binder (reference group);
       phosphate binder. Clinicians initiated     119 subjects who completed four           thanum carbonate is an effective
       treatment at a dose of 2,250 mg/day        weeks of treatment with both binders      phosphate binder for sustained con-          another group received neither med-
       for lanthanum carbonate (one 750-mg        and had a valid serum phosphorus          trol of serum phosphorus in dialysis         ication; a third group received
       tablet three times daily with meals)       measurement at week 4 of each treat-      patients,” the authors concluded.            oral vitamin D but not a phosphorus
       and 4,800 mg/day for sevelamer             ment period.                                “This is an important study as it is the   binder; and the fourth group
       hydrochloride (two 800-mg tablets            In the completer group, lanthanum       only randomized comparative study of         received a phosphorus binder but
       three times a day with meals), which       carbonate was associated with a signif-   two noncalcium containing phosphate          not vitamin D. Investigators followed
       was increased to 3,000 mg/day for          icant 0.50 mg/dL greater reduction in     binders,” Dr. Sprague told Renal &           patients for up to five years.
       lanthanum (three 1000-mg tablets           serum phosphorus at week 4 com-           Urology News. “This study demon-
                                                                                                                                           Compared with the reference group,
       daily) and 6400 mg/day (eight 800 mg       pared with sevelamer hydrochloride,       strated that three lanthanum carbonate
                                                                                                                                         the patients who did not take either
       tablets daily).                            Dr. Sprague’s group reported. In ad
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