Reductions in serum phosphorus shown to persist for up to six years.

ORLANDO, Fla.—Lanthanum carbonate provides sustained long-term reduction of serum phosphorus in dialysis patients.

The finding, by Michael Smyth, MRCGP, FRCS, and Lynne Poole, MSc, of Shire Pharmaceuticals in Basingstoke, U.K., which makes lanthanum carbonate, is based on data from a number of studies, including an open-label extension of four previous studies that followed up on patients who had received the phosphate binder for up to six years.

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At baseline, one of these studies had 93 patients. At 12 months, the 90 patients still in the trial had a mean reduction in serum phosphorus of 2.0 mg/dL compared with baseline, according to findings presented here at the National Kidney Foundation’s 2010 Spring Clinical Meetings. For the 21 patients still in the study at five years, the mean reduction in serum phosphorus from baseline was 2.4 mg/dL. At six years, the five remaining patients had a mean reduction of 2.3 mg/dL.

For most patients, these results were achieved with a lanthanum carbonate dose of up to 3000 mg/day, equivalent to a single 1000 mg tablet per meal.

The researchers cited a study by Mark D. Danese, MHS, PhD, and colleagues published in the Clinical Journal of the American Society of Nephrology (2008;1423-1429) showing that patients with serum phosphorus within the target range recommended by Kidney Disease Outcome Quality Initiative guidelines for all four quarters of the first year on dialysis had a 38% lower risk of death than subjects who had controlled serum phosphorus for one-quarter or less.

“In light of the findings of Danese et al., that consistent control of serum phosphorus may reduce mortality in dialysis patients, it is important to sustain reductions of serum phosphorus during long-term treatment,” the authors concluded.