Kidney Week

Abstract: SA-PO712

Patiromer and Maintenance of RAASI Therapy in Hyperkalemic Medicare Patients

Session Information

• Geriatric Nephrology
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

• 1100 Geriatric Nephrology

Authors

• Desai, Nihar, Yale School of Medicine, New Haven, Connecticut, United States

Nihar Desai,

• Rowan, Christopher G., COHRDATA, LLC, Santa Monica, California, United States

Christopher G. Rowan,

• Alvarez, Paula J., Relypsa, Inc., a Vifor Pharma Group Company, Redwood City, California, United States

Paula J. Alvarez,

• Fogli, Jeanene, Relypsa, Inc., a Vifor Pharma Group Company, Redwood City, California, United States

Jeanene Fogli,

• Toto, Robert D., University of Texas Southwestern Medical Center, Dallas, Texas, United States

Robert D. Toto,

Background

Continuing RAASI is critical for patients (pts) with high cardiovascular risk. Patiromer (PAT) is a Na-free non-absorbed K⁺-binder approved for hyperkalemia (HK) treatment in Oct 2015. PAT has been shown to reduce recurrent HK and allow pts to maintain RAASI. This retrospective cohort study evaluated RAASI utilization among Medicare Advantage pts with HK.

Methods

RAASI utilization was evaluated from a large, de-identified national health insurance claims database from 1/1/16 to 3/31/17. Three HK cohorts were identified based on: dispensed a K⁺-binder, either 1) patiromer [PAT cohort] or 2) SPS [SPS cohort], or 3) HK diagnosis code without a K⁺-binder dispensed (HK cohort). Pts were included who had a pre-index serum K⁺ ≥5.0 mEq/L and were continuously exposed to RAASI for ≥6 months pre-index (ie, date of first K⁺-binder dispensing or HK diagnosis). We evaluated RAASI continuation and down-titration (the latter assessed for lisinopril, losartan, and valsartan) within 1, 3, and 6 months post-index.

Results

Pre-index pt characteristics and sample sizes are listed in the Table. At 6 months post-index RAASI continuation rates were 87%, 72%, and 57% (Figure) and down-titration rates were 11%, 11%, and 9% in the PAT, SPS, and HK cohorts, respectively.

Conclusion

The highest RAASI continuation rate was observed in the PAT cohort across all time intervals, and down-titration rates in all 3 cohorts were low (~10%). Further study is warranted to fully elucidate these findings in early patiromer users.

Table: Pre-Index Patient Characteristics and Sample Sizes by Cohort.

Figure: RAASI Continuation Rates at 1, 3, and 6 Months Post-Index by Cohort.

Funding

• Commercial Support –