Tenapanor effectively treats hyperphosphatemia in patients receiving dialysis whether taken alone or in combination with phosphate binders, according to new research presented at the 58th European Renal Association-European Dialysis and Transplant Association congress.

Interim data from the OPTIMIZE study (Open-Label Study to Evaluate Potential Real-World Use of Tenapanor as the Core Therapy in the Treatment of Hyperphosphatemia in Patients with Chronic Kidney Disease on Dialysis; NCT04549597) showed that two-thirds of binder-naïve patients who started on tenapanor monotherapy achieved or maintained target phosphorus levels of less than 5.5 mg/dL over 10 weeks. Among the full cohort of patients, tenapanor helped approximately 50% achieve target phosphorus levels with or without the addition of reduced-dose phosphate binders.

Tenapanor inhibits intestinal sodium/hydrogen exchanger 3, tightening epithelial cell junctions, and reducing permeability phosphate. The starting dose of tenapanor in this trial was 30 mg twice daily, but could be downtitrated for better gastrointestinal tolerability.

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In a press release from the sponsor, lead researcher Steven Fishbane, MD, chief of nephrology for Northwell Health and professor of medicine at the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York, commented: “I am excited by these results that demonstrate both binder-treated and binder-naïve patients may be better able to achieve target phosphorus levels by applying a blocking mechanism approach as an integral component to hyperphosphatemia management, reflecting the important role of tenapanor across a broad range of patients and treatment regimen scenarios.”

Disclosure: This research was supported by Ardelyx. Please see the original references for a full list of disclosures.


Ardelyx Announces Presentations at ERA-EDTA Virtual Congress 2021 [news release]. Ardelyx; June 7, 2021.

Study to evaluate the use of tenapanor as core therapy in the treatment of hyperphosphatemia (OPTIMIZE). ClinicalTrials.gov Identifier: NCT04549597. Accessed July 30, 2021. https://clinicaltrials.gov/ct2/show/study/NCT04549597