The iron-based phosphate binder sucroferric oxyhydroxide shows similar 1-year efficacy to the ion-exchange resin sevelamer carbonate in peritoneal dialysis (PD) patients, a new study finds.
Jurgen Floege, MD, of RWTH University Hospital in Aachen, Germany, and colleagues performed a subanalysis of a phase 3 trial and its extension comparing sucroferric oxyhydroxide (1.0–3.0 g/day) with sevelamer (2.4–14.4 g daily) in dialysis patients. Of the original participants, 84 patients (8.1%) received PD, with 56 randomly assigned to sucroferric oxyhydroxide and 28 to sevelamer. No one had severe secondary hyperparathyroidism (intact parathyroid hormone levels above 800 ng/L).
Serum phosphorus declined an average 0.6 mmol/L in both groups over 12 weeks, according to results published in Nephrology Dialysis Transplantation. At 1 year, sucroferric oxyhydroxide had reduced serum phosphorus to a similar level as sevelamer in 62.5% vs 64.3% of patients, respectively. Both groups attained the Kidney Disease Outcomes Quality Initiative (KDOQI) target range of below 1.78 mmol/L.
Sucroferric oxyhydroxide recipients required fewer pills over the trial and extension periods: 3.4 vs 8.1 tablets daily. In addition, more than 90% adhered to treatment compared with 79.3% of sevelamer recipients.
The vast majority of patients in both groups experienced at least 1 treatment-emergent adverse event ( 86.0% vs 93.1%, respectively), typically a gastrointestinal problem. Serious adverse events were more common among sucroferric oxyhydroxide patients: 21 vs 7 patients.
The study was sponsored by Vifor Pharma in Switzerland, which manufactures sucroferric oxhydroxide (Velphoro).
Floege J, Covic AC, Ketteler M, et al. One-year efficacy and safety of the iron-based phosphate binder sucroferric oxyhydroxide in patients on peritoneal dialysis. Nephrol Dial Transplant 32:1918–1926. doi: 10.1093/ndt/gfw460