Side Effects Cited for Many Binder Discontinuations

Share this content:

SAN DIEGO—Nearly 11% of hemodialysis (HD) patients who discontinued use of a phosphate binder did so because of side effects, according to study findings presented at Kidney Week 2012.

Using electronic medical records of Medicare patients receiving HD at a large dialysis organization, Thomas Alfieri, PhD, of DaVita Inc., in Denver, and colleagues analyzed phosphate binder prescriptions and the reasons for discontinuation (either switched or ceased taking a binder entirely). Two independent coders classified each reason for discontinuation into six categories and subsequently into 40 subcategories.

Of 30,933 reasons classified, 50.1% of records indicated that the patient discontinued the binder but contained no additional information. Another 27.4% cited “lab results” as a reason for discontinuation and 10.8% cited “patient-reported side effects.”

Furthermore, the analysis revealed that lanthanum carbonate use was associated with a disproportionately high rate of discontinuation. Although 14% of patients in the study were prescribed lanthanum carbonate, they accounted for 40% of the patient-reported side effects.

The investigators concluded that the high percentage of reported side effects resulting in binder discontinuation identifies an unmet need for improved phosphate binders. In addition, although a disproportionate number of patients prescribed lanthanum carbonate reported side effects, more work is needed to identify the relative tolerability of phosphate binders and potential explanations, such as prescription bias.

You must be a registered member of Renal and Urology News to post a comment.

Sign Up for Free e-newsletters