Veltassa (patiromer) / CSL Behring - LARVOL DELTA

Epidemiology of Hyperkalemia Among United States Emergency Departments Patients without End-Stage Renal Disease from 2016-2023. (PubMed, Clin Exp Emerg Med) - "Sodium bicarbonate was given in 38.75%, calcium gluconate or chloride in 32.64%, sodium zirconium cyclosilicate in 24.68%, sodium polystyrene sulfonate in 23.12%, and patiromer in 3.04%. Among adult patients without ESRD, hyperkalemia is an uncommon but important condition, with twothirds requiring admission and two percent experiencing cardiac arrest. Sodium bicarbonate and calcium administration is common, while hemodialysis is rare."

Journal • Cardiovascular • Chronic Kidney Disease • Nephrology • Renal Disease

Comparative safety profiling of sodium zirconate cyclosilicate and patiromer using real-world FAERS data: A pharmacovigilance analysis. (PubMed, Medicine (Baltimore)) - "Positive signals for Patiromer also indicate concerns regarding product solubility, color, taste, and texture, potentially impacting patient compliance. Due to the high frequency of death reports associated with both drugs (SZC: 573, Patiromer: 1656), clinicians should exercise heightened vigilance."

Adverse events • Clinical • Journal • Real-world evidence • Cardiovascular • Congestive Heart Failure • Constipation • Gastroenterology • Gastrointestinal Disorder • Heart Failure

Acute hyperkalaemia in emergency care: evidence-based approaches. (PubMed, Emerg Med J) - "Newer potassium binders, including sodium zirconium cyclosilicate and patiromer, show promise in recent studies but require further validation in acute care settings. Haemodialysis remains the definitive option in refractory cases or patients with end-stage renal disease."

Journal • Review • Cardiovascular • Chronic Kidney Disease • Hypoglycemia • Metabolic Disorders • Nephrology • Renal Disease

Safety and efficacy of novel potassium binders for chronic hyperkalemia: a systematic review and meta-analysis of randomized controlled trials. (PubMed, Proc (Bayl Univ Med Cent)) - "Our meta-analysis, including 12 studies involving 2517 patients, showed that NPBs, including patiromer and sodium zirconium cyclosilicate, were associated with significant mineralocorticoid receptor antagonist (MRA) optimization (relative risk [RR]: 1.28; 95% confidence interval [CI]: 1.14-1.43) as compared to placebo. This meta-analysis highlights the potential of NPBs to facilitate MRA optimization, reduce hyperkalemic episodes, and maintain serum potassium levels in patients with hyperkalemia, without a corresponding increase in adverse events. However, further research through large-scale studies is needed to confirm the sustained clinical benefits of NPBs, establish standardized treatment protocols, and evaluate their effectiveness across diverse patient populations with CKD and HF."

Journal • Retrospective data • Review • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Heart Failure • Nephrology • Renal Disease

PAT-CHINA-303: Trial Evaluating the Efficacy and Safety of Patiromer in Chinese Subjects (clinicaltrials.gov) - P3 | N=262 | Completed | Sponsor: Vifor Fresenius Medical Care Renal Pharma | Active, not recruiting ➔ Completed

Trial completion • Chronic Kidney Disease • Nephrology • Renal Disease

PROMISE: Potassium Correction for RAAS Optimization in Chronic Kidney Disease (clinicaltrials.gov) - P4 | N=44 | Recruiting | Sponsor: University Medical Center Groningen | Trial completion date: Dec 2026 ➔ Dec 2027

Trial completion date • Cardiovascular • Chronic Kidney Disease • Hypertension • Nephrology • Renal Disease

PAT-CHINA-303: Trial Evaluating the Efficacy and Safety of Patiromer in Chinese Subjects (clinicaltrials.gov) - P3 | N=262 | Active, not recruiting | Sponsor: Vifor Fresenius Medical Care Renal Pharma | Recruiting ➔ Active, not recruiting

Enrollment closed • Chronic Kidney Disease • Nephrology • Renal Disease

Managing Hyperkalemia in Heart Failure Patients: A Systematic Review. (PubMed, Cardiol Rev) - "For chronic management, newer potassium-binding agents such as patiromer and sodium zirconium cyclosilicate offer improved safety and efficacy compared with traditional resins, enabling the continuation and up-titration of renin-angiotensin-aldosterone system inhibitors. These therapies support optimal neurohormonal blockade, improve adherence, and reduce morbidity and mortality in heart failure."

Journal • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Nephrology • Renal Disease

Changes in Albuminuria (ACR) in Patients with Hyperkalemic (HK) CKD Taking Patiromer (PAT) and RAAS Inhibitors (RAASi) (KIDNEY WEEK 2025) - "Cohorts 1 & 2 (TIP n=61; LTMP n=48) received guideline-directed medical therapy with losartan 100 mg daily, with or without spironolactone and treated with PAT. Given the observational nature of these analyses & the variability in patient populations, further studies are needed to confirm these results & clarify their clinical significance. Figure: Median ACR changes in OPAL-HK (Part A) and AMETHYST-DN studies"

Clinical • Chronic Kidney Disease • Diabetes • Metabolic Disorders • Renal Disease

Hyperkalemia in the Time of Zirconium and Patiromer (KIDNEY WEEK 2025) - "This session provides the latest clinical guidance to help make sense of all these changes. Learning Objective(s) Identify the diagnostic pathways to determine the etiology of hyperkalemia Explain the role of potassium binders in the treatment of hyperkalemia Explain the role of potassium control in CKD treatment Describe the treatment of acute hyperkalemia in the modern era"

Chronic Kidney Disease

Strategies for hyperkalemia management in dialysis patients: A systematic review. (PubMed, Open Med (Wars)) - "The aim of this systematic review is to evaluate current therapeutic strategies for hyperkalemia in dialysis patients, including diuretics, ion-exchange resins, and newer agents such as sodium zirconium cyclosilicate (SZC)...New therapies like SZC and patiromer demonstrated efficacy in maintaining safe potassium levels...Hyperkalemia management in dialysis patients benefits from an integrated approach combining pharmacologic treatment, tailored nutrition, and close monitoring. Novel interventions and evolving dietary guidelines may improve safety, effectiveness, and quality of life in this vulnerable population."

Journal • Review • Chronic Kidney Disease • Nephrology • Renal Disease

The Economic Burden of Parkinson's Disease in the Netherlands: From Societal Impact to Investments in Health Solutions (ISPOR-EU 2025) - "In the Netherlands, the aging population is expected to drive a substantial increase in PD prevalence, from 67,000 in 2022 to nearly 105,000 by 2040, intensifying pressure on the healthcare system and informal care networks... PD poses a growing societal and economic burden in the Netherlands, with major impacts beyond the healthcare sector. Future research should focus on understanding key cost drivers and explore strategies to mitigate the projected burden. Topics such as integrated care, toxin exposure prevention and lifestyle interventions will be crucial."

HEOR • CNS Disorders • Movement Disorders • Parkinson's Disease

Net clinical benefit of patiromer for acute hyperkalemia: a post-hoc analysis of the reduce trial. (PubMed, Ann Med) - "NCB for PAT over SOC was numerically superior at 2 h (-0.05 vs 0.43; p = 0.108), 4 h (0.11 vs 0.73; p = 0.097), and 6 h (0.64 vs 1.60; p = 0.094) post-intervention. NCB captures the clinical benefit of binders, while accounting for the confounding effect of other potassium-lowering agents."

Clinical • Journal • Retrospective data

Impact of Potassium-Binders on the Interpretation of Bone Mineral Density Following Kidney Transplantation. (PubMed, Clin Transplant) - "The potassium lowering drug sodium zirconium cyclosilicate (Lokelma) is radiopaque and therefore acts as a confounder on DXA interpretations in kidney transplant recipients. Patiromer (PAT, Veltassa) has no such effect."

Journal • Gastrointestinal Disorder • Transplantation

Colossal and tunable dielectric tunability in domain-engineered barium strontium titanate. (PubMed, Nat Commun) - "Using phenomenological modeling, film growth, and characterization, we show that devices consisting of domain-wall-rich Ba0.8Sr0.2TiO3 films close to a polar-domain-variant phase boundary exhibit colossal dielectric tunability of 100:1 (99%) at a voltage (electric field) of ~15 V (750 kV/cm), resulting in a tunability-quality factor product figure of merit that rises to nearly 105, two orders of magnitude higher than the best previous reported values. Remarkably, varying the amplitude of alternating-current bias enables modulation of this tunability by 50%, owing to domain-wall motion. These results suggest that domain engineering is a powerful approach for achieving excellent modulation of functional properties in ferroelectric films."

Journal

Differences in Efficacy Among New and Old Potassium Binders in Dialysis Patients: A Systematic Review and Meta-Analysis. (PubMed, G Ital Nefrol) - "Newer potassium binders, patiromer and sodium zirconium cyclosilicate (SZC), offer improved tolerability compared to older agents. The lack of sufficient RCTs, especially those directly comparing newer binders, highlights a significant knowledge gap. Further studies are needed to evaluate long-term outcomes, including quality of life and cardiovascular effects, and to directly compare the efficacy and safety of different potassium binders in this population."

Clinical • Journal • Retrospective data • Review • Cardiovascular

PRINCE: Patiromer and Diet/hrQoL in Chronic Dialysis (clinicaltrials.gov) - P3 | N=40 | Recruiting | Sponsor: Mario Negri Institute for Pharmacological Research | Not yet recruiting ➔ Recruiting

Enrollment open • HEOR • Chronic Kidney Disease • Nephrology • Renal Disease

PRINCE: Patiromer and Diet/hrQoL in Chronic Dialysis (clinicaltrials.gov) - P3 | N=40 | Not yet recruiting | Sponsor: Mario Negri Institute for Pharmacological Research | Trial completion date: Feb 2026 ➔ Jul 2026 | Trial primary completion date: Feb 2026 ➔ Jul 2026

HEOR • Trial completion date • Trial primary completion date • Chronic Kidney Disease • Nephrology • Renal Disease

KBindER: Comparison of Potassium Binders in the ER (clinicaltrials.gov) - P4 | N=37 | Terminated | Sponsor: University of California, Irvine | N=120 ➔ 37 | Trial completion date: Dec 2025 ➔ Jan 2025 | Recruiting ➔ Terminated | Trial primary completion date: Jul 2025 ➔ Jan 2025; Low enrollment rate

Enrollment change • Trial completion date • Trial primary completion date • Trial termination

Management of patients with heart failure at high risk of hyperkalaemia: The CARE-HK in HF registry. (PubMed, Eur J Heart Fail) - P | "In this contemporary multinational prospective registry of patients with HF at high risk for hyperkalaemia, hyperkalaemic events were common but infrequently associated with RASi/MRA modification or potassium binder use. Fewer than one in three patients received optimal RASi/MRA therapy for the majority of follow-up, and hyperkalaemic events were associated with higher risk of adverse clinical outcomes."

Journal • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Heart Failure • Nephrology • Renal Disease

Hyperkalemia in Heart Failure with Reduced Ejection Fraction: Implications and Management. (PubMed, Heart Fail Rev) - "This review explores the complex interplay between hyperkalemia and the use of guideline-directed medical therapies (GDMT), such as renin-angiotensin-aldosterone system inhibitors (RAASi) and steroidal mineralocorticoid receptor antagonists (sMRAs), including spironolactone and eplerenone, which are currently recommended in guidelines for improving outcomes in heart failure with reduced ejection fraction (HFrEF)...This review emphasizes the importance of regular potassium monitoring, the potential benefits of combining therapies such as sodium-glucose cotransporter 2 (SGLT2) inhibitors with RAASi to reduce the risk of hyperkalemia, and the emergence of the newer non-steroidal MRA (nsMRA), finerenone, which may have a lower risk of hyperkalemia. Additionally, potassium binders such as patiromer and sodium zirconium cyclosilicate (SZC) are highlighted for their role in managing and preventing hyperkalemia, allowing patients to continue optimal RAASi and MRA therapy without..."

Journal • Review • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Nephrology • Renal Disease

Comparison of Three Potassium Binders in Patients With Acute Hyperkalemia. (PubMed, Cureus) - "SPS and SZC were superior to patiromer in lowering serum potassium levels in patients with acute hyperkalemia, with no significant difference between SPS and SZC. Considering the established safety concerns associated with SPS, SZC may be the preferred binder for managing acute hyperkalemia in the inpatient setting."

Journal • Cardiovascular • Chronic Kidney Disease • Nephrology • Renal Disease

Novel Drugs and Hyperkalemia: Risks and Solutions: Electrolyte Disorders in CKD and the Elderly: Clinical Challenges and Emerging Solutions (KSN 2025) - "Recently, finerenone, a non-steroidal mineralocorticoid receptor antagonist has become available to treat patients with type 2 diabetes...Sacubitril/valsartan, a new pharmacological class of angiotensin receptor neprilysin inhibitor, is beneficial to heart failure through blocking the degradation of natriuretic peptides and inhibiting renin-angiotensin-aldosterone system (RAAS) activation which also relate to the pathophysiologic mechanisms of chronic kidney disease...Patiromer and sodium zirconium cyclosilicate (SZC) are newer options for hyperkalemia treatment...Recent randomized clinical trials have shown that SZC effectively lowers serum potassium and maintains normokalemia in most hyperkalemic patients. It is likely these newer oral potassium-binding agents will help change how patients with hyperkalemia are treated in regards to sudden and chronic medical conditions."

Clinical • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Nephrology • Type 2 Diabetes Mellitus

Hyperkalemia in Hemodialysis: Use of Sodium Zirconium Cyclosilicate - A Single-center Experience (PubMed, G Ital Nefrol) - "Recently, two new medications have been introduced for chronic potassium control: Patiromer and Sodium Zirconium Cyclosilicate, the latter approved for use in haemodialysis. We conducted an observational study at our dialysis unit on 28 chronic haemodialysis patients, where after detecting hyperkalaemia, therapy with Sodium Zirconium Cyclosilicate was initiated. We evaluated the potassium levels over time, changes in home treatments, and the drug's tolerability."

Journal • Observational data • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Nephrology • Renal Disease

Changes in natriuretic peptide levels following patiromer-enabled optimization of medical therapy in heart failure: A post hoc analysis of the DIAMOND study. (PubMed, Eur J Heart Fail) - "In this post-hoc analysis of DIAMOND, patients with HFrEF and elevated (>1000 ng/ml) NT-proBNP at screening experienced clinically meaningful NT-proBNP reductions following a RAASi optimization strategy that included patiromer during the run-in phase, with no significant differences observed between patiromer and placebo groups during the randomized withdrawal phase."

Journal • Retrospective data • Cardiovascular • Congestive Heart Failure • Heart Failure