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Elderly Dialysis Patients Achieve Better Mortality Outcomes With Lanthanum Carbonate Versus Calcium-Based Phosphate Binders: Presented at ASN

By Maggie Schwarz

PHILADELPHIA -- November 9, 2008 – Non-calcium-based phosphate binders, including lanthanum carbonate, may improve outcomes in dialysis patients aged above 65 years, researchers reported at Renal Week 2008, the American Society of Nephrology (ASN) annual meeting.

Extensive data link elevated serum phosphorus with increased risk of death in patients with stage 5 chronic kidney disease (CKD). The exact impact of specific phosphate binders on survival, however, remains unclear. Increasing evidence suggests that effective serum phosphorus control, particularly with non-calcium-based phosphate binders, may reduce the risk of vascular calcification, potentially improving clinical outcomes in patients with CKD.

Subjects in this study were randomized 1:1 to lanthanum carbonate or their prestudy phosphate binder; the doses were then titrated to achieve a serum phosphorus level <=5.9 mg/dL. These doses were maintained for 2 years.

Survival was evaluated retrospectively for the study population overall and for subgroups found to be important in the Dialysis Clinical Outcomes Revisited study.

Coinvestigator Raymond D. Pratt, PhD, Shire Pharmaceuticals, Wayne, Pennsylvania, reported the results of the study on behalf of his team at a poster presentation on November 6. Survival status was available for 680 patients taking lanthanum carbonate and 674 taking standard therapy.

Analysis of the survival data demonstrated no significant difference in overall mortality between the treatment groups, although mortality was marginally lower with lanthanum carbonate.

In a subgroup analysis, however, mortality was significantly lower in patients aged above 65 years who were treated with lanthanum carbonate (P = .04). In the lanthanum carbonate group, 27% (44 of 163) of the patients died. In the group taking standard therapy, 39% (68 of 173) died.

Funding for this study was provided by Shire Pharmaceuticals plc.

[Presentation title: Retrospective Outcomes Analyses of a 2-Year Comparative Study of Lanthanum Carbonate vs Standard Therapy. Abstract TH-PO928]

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