Abstract: FR-PO1073

Comparison of Lanthanum Carbonate with Calcium Carbonate for the Progression of Coronary Artery Calcification in Hemodialysis Patients

Session Information

Category: Mineral Disease

  • 1205 Vascular Calcification

Authors

  • Ogata, Hiroaki, Showa University School of Medicine, Yokohama, Japan
  • Fukagawa, Masafumi, Tokai University School of Medicine, Isehara, KANAGAWA, Japan
  • Hirakata, Hideki N., Fukuoka Renal Clinic, Fukuoka City, Japan
  • Kagimura, Tatsuo, Translational Research Informatics Center, Kobe, Japan
  • Akizawa, Tadao, Showa University School of Medicine, Yokohama, Japan

Group or Team Name

  • On behalf of the LANDMARK Study Group
Background

The LANDMARK study is a multicenter, randomized, open-label, parallel assignment study comparing the effects on cardiovascular mortality and morbidity of a non-calcium phosphate (P) binder, lanthanum carbonate (LC), with calcium carbonate (CC) in hemodialysis patients. This adjunct study (LANDMARK-SS) investigated whether LC delayed the progression of coronary artery calcification compared with CC.

Methods

Adult hemodialysis patients with at least one risk factor for vascular calcification (age >65 years, postmenopausal women, type 2 diabetes mellitus), were randomly assigned to receive LC or CC. Doses of LC and CC were titrated to achieve target serum P levels of 3.5–6.0 mg/dL. If this was not achieved with the maximum tolerated dose, other non-calcium-based P binders were added in the LC group and P binders other than LC in the CC group. The primary endpoint was the change in Agatston coronary artery calcification score (CACS) from baseline.

Results

Median changes in CACS in the LC and CC groups were 360 (95% confidence interval [CI], 180–541) and 211 (95%CI 77–366), respectively, at 1 year, and 368 (95%CI 57–680) and 611 (95%CI 105–1118) at the end of the 2-year study. The increase in CACS appeared to lessen after 1 year with LC, but these differences were not statistically significant, and stratified analysis based on concomitant treatment, age, and baseline CACS also showed no significant differences in CACS progression between groups.

Conclusion

We conclude that LC did not significantly attenuate calcification in comparison with CC over 2 years in hemodialysis patients.

Changes in total Agatston CACS from baseline

Funding

  • Commercial Support