Ferric Citrate Controls Phosphorus, Cuts ESA Use

Over 52 weeks, the drug maintained hemoglobin levels while decreasing IV iron use in dialysis patients.
Over 52 weeks, the drug maintained hemoglobin levels while decreasing IV iron use in dialysis patients.

PHILADELPHIA—Ferric citrate is an efficacious and safe phosphate binder that increases iron stores and decreases the use of intravenous (IV) iron and erythropoiesis-stimulating agents (ESAs) over 52 weeks, researchers reported at the 2014 Kidney Week meeting.

The phase 3 open-label trial, led by Julia B. Lewis, MD, of Vanderbilt University in Nashville, Tenn., included 166 patients previously enrolled in a pivotal 4-week trial in which they received either ferric citrate or active control.

In the new study, which extends observations by another 48 weeks, patients received ferric citrate that, as before, was supplied as 1 gram tablets containing 210 mg of iron.

Mean phosphorus levels declined from 5.7 mg/dL at baseline to 5.2 mg/dL at week 48, according to the investigators.

From baseline to week 48, transferrin saturation increased from 32.4% to 40.3% and serum ferritin increased from 710 to 821 ng/mL. From week 12 to week 48, IV iron use decreased from 1.48 to 0.72 mg per day, ESA use declined from 893 to 699 units per day, and hemoglobin levels remained stable at 11.3 g/dL.


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