Abstract: PO0540
Pill Burden and Changes in Mineral Bone Disorder (MBD) Markers in Hemodialysis (HD) Patients Switched from Sevelamer to Sucroferric Oxyhydroxide (SO): A One-Year Follow-Up in a Contemporary Cohort
Session Information
- Bone and Mineral Metabolism: Clinical
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Zhou, Meijiao, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Ficociello, Linda, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Parameswaran, Vidhya, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Mullon, Claudy, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Anger, Michael S., Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
Background
About 80% of US dialysis patients are prescribed phosphate binders (PB) for serum phosphorus (sP) control; however, PB high pill burdens are associated with non-adherence and elevated sP levels. Clinical and observational studies have demonstrated that SO is effective in lowering sP with similar efficacy to sevelamer (Sev), but with a lower pill burden. The present study aims to assess the long-term changes in MBD markers and pill burden in a contemporary HD cohort switching from Sev to SO.
Methods
The study included adult, Fresenius Kidney Care maintenance HD pts receiving Sev during a 91-day baseline (BL) and first prescribed SO monotherapy during 5/2018- 5/2019. The one year follow up (FU) on SO therapy was divided into four consecutive 91-day intervals (Q1-Q4). Comparisons of PB pill burden and MBD markers between BL and FU were carried out using mixed-effects linear regression and Cochran's Q test.
Results
On average, patients (n=841) were 56.2 (13.3) years old with dialysis vintage of 50.5 (48.6) months. At BL, the % of pts was 21.2% for sP ≤ 5.5 mg/dL and 4.5% for sP≤ 4.5 mg/dL with 8.4 Sev pills/day; after switching to SO, the % of patients increased to 35.4%- 44.0% for sP ≤ 5.5 mg/dL and 11.4%-16.1% for sP≤ 4.5 mg/dL with 4.4- 4.9 pills/day. Mean iPTH and serum calcium (Ca) decreased progressively after SO conversion.
Conclusion
Maintenance HD patients switching PB prescription from Sev to SO during 2018 and 2019 as part of routine care showed significant reductions in sP and PB pill burden, and increases in the number of patients with sP ≤5.5mg/dL and sP ≤ 4.5 mg/dL. A trend toward decreased serum Ca and iPTH levels during SO therapy was also observed.
| BL: -Q1 (ref) | SO Q1 | SO Q2 | SO Q3 | SO Q4 | P- value | |
| PB, pills/day | 8.4 | 4.4** | 4.6** | 4.9** | 4.9** | <.001 |
| sP≤ 5.5 mg/dL, % | 21.2 | 35.4** | 44.0** | 43.8** | 41.1** | <.001 |
| sP≤ 4.5 mg/dL, % | 4.5 | 11.4** | 15.8** | 16.4** | 15.1** | <.001 |
| sP, mg/dL | 6.55 | 6.14** | 5.92** | 5.92** | 5.98** | <.001 |
| iPTH, pg/ml | 628 | 592** | 579** | 578** | 565** | <.001 |
| Calcium, mg/dL | 9.14 | 9.13 | 9.09** | 9.04** | 9.02** | <.001 |
*P<0.05; **P<.001 (vs. BL)
Funding
- Commercial Support –