Patiromer

The First Potassium Binder Approved in Over 50 Years

Betty N. Vu, Alyssa Mae de Castro, David Shottland, William H. Frishman, Angela Cheng-Lai

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

For over 50 years, there have been limited options for the management of hyperkalemia, especially among patients with chronic kidney disease (CKD), diabetic nephropathy, hypertension, as well as heart failure, who were receiving concomitant renin angiotensin-aldosterone-system (RAAS) inhibitor therapy. Hyperkalemia is a potential, life-threatening electrolyte abnormality that frequently challenges clinicians from maximizing the mortality benefit and organ protective properties of RAAS inhibitors especially in CKD and heart failure populations. Patiromer is a novel non-absorbed, cation-exchange polymer that binds and exchanges potassium for calcium, predominantly in the gastrointestinal tract. It has demonstrated potassium-lowering effects in normo- or hyperkalemic patients on concomitant RAAS inhibitors with heart failure, diabetic nephropathy, and CKD, in the PEARL-HF, AMETHYST-DN, and OPAL-HK studies, respectively. Across all studies, it appears to be generally effective and well-tolerated, with adverse events predominantly gastrointestinal in nature. Additional investigational studies are needed to explore its use for an extended duration of treatment, and in larger patient populations, as well as exploring drug-drug interactions. Overall, patiromer demonstrates a promising role in the chronic management of hyperkalemia that will allow optimization of RAAS inhibitor therapy, thus delaying progression of CKD and improving the mortality benefit in heart failure patients.

Original languageEnglish (US)
JournalCardiology in Review
DOIs
StateAccepted/In press - Aug 18 2016

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Renin-Angiotensin System
Chronic Renal Insufficiency
Hyperkalemia
Potassium
Diabetic Nephropathies
Heart Failure
Mortality
Drug Interactions
Electrolytes
Population
Chronic Kidney Failure
Gastrointestinal Tract
Cations
Polymers
Therapeutics
Hypertension
Calcium
patiromer
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Patiromer : The First Potassium Binder Approved in Over 50 Years. / Vu, Betty N.; de Castro, Alyssa Mae; Shottland, David; Frishman, William H.; Cheng-Lai, Angela.

In: Cardiology in Review, 18.08.2016.

Research output: Contribution to journalArticle

Vu, Betty N. ; de Castro, Alyssa Mae ; Shottland, David ; Frishman, William H. ; Cheng-Lai, Angela. / Patiromer : The First Potassium Binder Approved in Over 50 Years. In: Cardiology in Review. 2016.
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