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Tags: Diabetes | Heart Disease | potassium | drugs | patriomer | ZS-9 | heart

Two Drugs Found Effective in Treating Excess Potassium

Friday, 21 November 2014 04:45 PM

Two experimental drugs can reduce dangerously high potassium levels in the blood, a problem that can plague people with diabetes and kidney disease and lead to a fatal heart rhythm, researchers say.

The findings are from two separate studies financed by the manufacturers and released Friday by the New England Journal of Medicine.

The oral drugs are sodium zirconium cyclosilicate (also known as ZS-9 and being developed by ZS Pharma) and patriomer (developed by Relypsa).

Both drugs treat high potassium by binding to it as they travel through the gut.

If the drugs are approved -- and longer-term tests are needed before that happens -- they could change the way doctors treat kidney disease and heart failure.

That's because a high potassium level in the blood, or hyperkalemia, is a potentially deadly side effect of a specific class of drugs used for kidney and heart problems, called RAAS inhibitors.
 
 
 

"Doctors are paranoid about hyperkalemic death when they use these kidney- and heart- protective drugs. So they won't use them, or they use them in much lower doses than they should," said Dr. Matthew Weir of the University of Maryland School of Medicine and chief author of the patiromer study.

The two new drugs should alleviate some of that concern, Weir told Reuters Health in a telephone interview.

Dr. David Packham of the University of Melbourne, chief author of the ZS-9 study, foresees a significant benefit for the drug he tested.

"Because the effect can be maintained, in this case for 14 days, it has the potential for being an enabling therapy that enables you to keep patients on treatments that benefit them that often have to be reduced in dose because of hyperkalemia," he said by phone.

"What this does is reliably and very rapidly - within 48 hours - dramatically reduce potassium levels," said Packham. "You could see where the patients who were (taken off ZS-9) went back up to their previous potassium levels over the 14-day period, whereas the levels were maintained in the patients who were kept on ZS-9. And when they were taken off, the levels went back up again. It was very, very clear."

"The drug was equally effective across various subgroups, including patients with a combination of heart failure, chronic kidney disease, and diabetes," the researchers concluded.

"I think it will become the standard for treatment for acute hyperkalemia," Packham said.
Weir expressed a similar sentiment for patiromer.

That test, involving patients with high potassium levels who were getting RAAS inhibitors for their long-term kidney disease, "is quite a definitive study," he said. "It's a study done exclusively in people with chronic kidney disease receiving the lone therapy we know of that slows the progression of kidney disease."

After four weeks of patiromer therapy, potassium levels had fallen into the normal range for 76 percent of the patients.

Among 52 volunteers who were then taken off the drug and given a placebo instead, potassium returned to unacceptably high levels in 60 percent. Yet among the 55 patients who were kept on the drug, only 15 percent redeveloped hyperkalemia at the eight-week mark.

Nearly half the patients on the drug had at least one side effect, a rate that was similar among placebo recipients. The most common side effect was mild-to-moderate constipation, which surfaced in 11 percent. Potassium levels dropped too far in 3 percent.

With ZS-9, at least one side effect was reported at some point in a quarter of the patients in each group. The most common side effect was diarrhea, seen in 1.8 percent of patients taking the drug and 2.5 percent with placebo. In two patients, potassium levels dropped too far, but the effect was temporary.

Weir said the two drugs rely on different mechanisms, may have different side effects and have yet to be pitted against each other in a study. "But I think both are going to be heads and tails above existing therapies."

© 2021 Thomson/Reuters. All rights reserved.


Health-News
Two experimental drugs can reduce dangerously high potassium levels in the blood, a problem that can plague people with diabetes and kidney disease and lead to a fatal heart rhythm, researchers say.The findings are from two separate studies financed by the manufacturers and...
potassium, drugs, patriomer, ZS-9, heart
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2014-45-21
Friday, 21 November 2014 04:45 PM
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