WASHINGTON—Patiromer may control serum potassium for up to 1 year in patients with advanced diabetic kidney disease taking renin-angiotensin-aldosterone system inhibitors (RAASi) who develop hyperkalemia, according to new study findings presented at the American Society of Nephrology’s Kidney Week 2019. Patients experienced benefit regardless of age.

Matthew Weir, MD, of the University of Maryland School of Medicine in Baltimore, and colleagues conducted a post-hoc analysis of the AMETHYST-DN trial, involving 304 patients on RAASi with an estimated glomerular filtration rate (eGFR) of at least 15 but less than 60 mL/min/1.73m2, type 2 diabetes, hypertension, and serum potassium exceeding 5.0 mEq/L. Of these, 122, 122, and 60 patients were younger than 65 years, 65 to 74 years, and 75 years or older, respectively. At baseline, mean serum potassium levels were 5.32, 5.31, and 5.19 mEq/L, respectively.

Patiromer, a sodium-free, non-absorbed potassium binder, was titrated to achieve serum potassium of 5.0 mEq/L or less. By day 3, after the first dose of patiromer, mean serum potassium had dropped to 4.97, 4.90, and 4.89 mEq/L in the 3 age groups, respectively. By 4 weeks of treatment, serum potassium had fallen significantly by a mean 0.67, 0.82, and 0.65 mEq/L, respectively, compared with baseline. By 52 weeks of treatment, significant mean potassium reductions of 0.66, 0.68, and 0.61 mEq/L from baseline, respectively, had been maintained.

Over the trial period, 18%, 23%, and 17% of patients reported at least 1 patiromer-related adverse event, most commonly constipation. A total of 9%, 9%, and 10% of patients, respectively, discontinued patiromer.

The study was funded by Relypsa, Inc, the makers of patiromer (Veltassa).

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Reference

Weir MR, Mayo M, Garza D, et al. Patiromer controls serum potassium for up to 1 year in hyperkalemic patients with diabetes and advanced kidney disease on RAAS inhibitors regardless of age. Presented at the American Society of Nephrology’s Kidney Week 2019 meeting held November 5 to 10, 2019, in Washington DC. Abstract FR-PO255.