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Kidney Week

Abstract: PO0381

Real-World Effectiveness of Sucroferric Oxyhydroxide (SO) in Lowering Serum Phosphorus (sP) Among a Contemporary Hemodialysis (HD) Cohort: A 6-Month Follow-Up

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Coyne, Daniel W., Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, United States
  • Zhou, Meijiao, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Parameswaran, Vidhya, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Ficociello, Linda, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Mullon, Claudy, Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Anger, Michael S., Fresenius Medical Care Renal Therapies Group, Waltham, Massachusetts, United States
  • Sprague, Stuart M., NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Evanston, IL, USA, Evanston, Illinois, United States
Background

Clinical trial and real-world data demonstrated the effectiveness of SO in managing sP among dialysis pts. Previous real-world analyses included HD pts prescribed SO within the first 2 years following SO availability in the US (2014 Cohort, Coyne 2017). With greater physician experience with SO and increased availability, prescription patterns may have changed over time. The current retrospective study assessed changes in sP and phosphate binder (PB) pill burden in pts prescribed SO in 2018-2019 (2018 Cohort) and compare these results to the 2014 Cohort findings.

Methods

We included adult Fresenius Kidney Care HD pts first prescribed SO monotherapy between 5/2018- 5/2019, on other PB monotherapy during a 3-month baseline (BL), and had sP measured the month before SO start and in >5 months during SO. We compared BL to quarterly (Q1, Q2) means, calculated using mixed-effects linear regression, for PB pill burden and lab measurements.

Results

Compared to the 2014 Cohort, the 2018 cohort (n=2018) was larger (vs 424), older (56 vs 51 years) with shorter dialysis vintage (47 vs 56 months), more likely prescribed calcium acetate (42 vs 22%) and less likely prescribed sevelamer (41 vs 63%). The 2018 Cohort had better BL sP control (25.7 vs 15.6% pts with sP≤ 5.5 mg/dL), yet in both cohorts SO conversion was associated with significant reductions in sP (6.39 to 6.00 vs. 6.86 to 6.41) and PB pills/day (7.6 to 4.4 vs. 9.7 to 4.0). % pts with sP ≤ 5.5 mg/dL increased from 15.6 to 30.4% in 2014 Cohort and 25.7 to 41.3% in Cohort 2018.

Conclusion

Similar to the 2014 Cohort, a contemporary cohort of HD pts converted to SO experienced improvements in sP and achieving sP ≤ 5.5 mg/dL with fewer PB pills/day. Physicians are prescribing SO to a broader patient population with different distributions of baseline PB therapy.

 BL; -Q1
(ref)
SO Q1SO Q2P-Value
Phosphate binder pills/day7.64.3**4.4**<0.001
Serum phosphorus (sP), mg/dL6.396.13**6.0**<0.001
Patients with sP ≤ 5.5 mg/dL, %25.736.9**41.3**<0.001
Serum calcium, mg/dL9.109.07**9.0**<0.001
Intact PTH, pg/mL5825755860.17

**P<0.001 (vs. BL) Mixed effects linear regression and Cochran's Q test were used to test for statistical significance

Funding

  • Commercial Support