Velphoro (sucroferric oxyhydroxide) / Fresenius Kabi, Kissei, CSL Behring - LARVOL DELTA

Age-Related Hyperphosphatemia Is Associated with Metabolic and Mitochondrial Alterations During Myogenic Differentiation and in Skeletal Muscle from Old Mice. (PubMed, Int J Mol Sci) - "In addition, quadriceps muscles from four experimental groups of male C57BL/6J mice were analyzed: young (5 months) and old (24 months) fed with standard diet; old mice fed with hypophosphatemic diet or supplemented with the phosphate binder Velphoro®, for the last three months of life...Altogether, hyperphosphatemia induces metabolic changes that scale with the sarcopenic degree. Our findings show a relevant association between hyperphosphatemia and mitochondrial dysfunction, and they support the potential benefit of phosphate reduction as a strategy to prevent or mitigate sarcopenia."

Journal • Preclinical • Metabolic Disorders • Nephrology • Renal Disease • Sarcopenia • LDHA • PGK1 • SLC2A1 • SOD2

Phosphate binders and the gut microbiota in chronic kidney disease: mechanisms, mixed evidence, and clinical considerations. (PubMed, J Nephrol) - "Evidence on their microbiome effects is mixed: some studies show minimal compositional changes with calcium acetate or sucroferric oxyhydroxide, while others report individual variability and subtle taxon-specific shifts, particularly with iron-based binders...Overall, current evidence remains heterogeneous and limited by small cohorts and preclinical designs. Although microbiota-targeted therapies show mechanistic promise, robust clinical trials are needed before they can be recommended beyond adjunctive use."

Journal • Chronic Kidney Disease • Inflammation • Metabolic Disorders • Nephrology • Renal Disease

Comparative Effectiveness and Safety of Phosphorus-Lowering Drugs for CKD 3-5 Stages. (PubMed, Kidney Med) - "Sucroferric oxyhydroxide (PA21), nicotinic acid, and tenapanor were most likely to be ranked the best, second best, or third best...Colestilan, tenapanor, and PA21 posed a higher risk for gastrointestinal discomfort...PA21 has the best phosphorus-lowering effect in hyperphosphatemic adults with chronic kidney disease; considering efficacy and safety, calcium carbonate shows evidence of being the most appropriate drug with or without dialysis. Registered at PROSPERO (CRD42024500243)."

HEOR • Journal • Review • Chronic Kidney Disease • Endocrine Disorders • Gastrointestinal Disorder • Metabolic Disorders • Nephrology • Renal Disease

Clinical Pharmacokinetic-Pharmacodynamic Relationships of Pharmacological Strategies for Attenuating p-Cresyl Sulfate in Patients with Kidney Disease. (PubMed, Clin Pharmacokinet) - "The studies included AST-120 (n = 3), sevelamer (n = 9), sucroferric Noxyhydroxide (n = 1 [+ 1 overlapping with sevelamer]), prebiotics (n = 15), probiotics (n = 9), synbiotics (n = 13), antibiotics (n = 3), ketoanalogs (n=3), and curcumin (n = 3)...In contrast, the majority of sucroferric oxyhydroxide, prebiotics, probiotics, ketoanalogs, and curcumin studies did not demonstrate consistent pCS reductions...In Ngeneral, it was also difficult to establish associations with outcomes in most studies because of limitations in experimental design, and in instances where potential pharmacokinetic-pharmacodynamic relationships were observed, they were generally weak and only with surrogate markers of commonly measured biochemistry, oxidative stress, lipid profiles, and inflammatory markers, with only a handful of studies capturing clinical outcomes. In conclusion, we have identified potential pharmacological interventions that may be further developed for the purpose of..."

Journal • PK/PD data • Review • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Heart Failure • Myocardial Infarction • Nephrology • Renal Disease • Transplantation

Oxylanthanum Carbonate Achieves Serum Phosphate Control with Significantly Lower Pill Burden in Patients with Hyperphosphatemia on Dialysis (KIDNEY WEEK 2025) - "Pretrial PB included sevelamer carbonate, calcium acetate, ferric citrate, and sucroferric oxyhydroxide. Combined with previously presented safety data, these findings suggest that OLC is safe, effective, and well-tolerated. Its small, easy-to-swallow formulation may be a welcome choice for pts with HP."

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

EARLY DIAGNOSIS OF HYPERPHOSPHATEMIC FAMILIAL TUMORAL CALCINOSIS IN AN INFANT (ESPN 2025) - "Incidence of HFTC is low, albeit it should be suspected in cases of persistent hyperphosphatemia, allowing early detection of disease and optimal patient management."

Metabolic Disorders • Musculoskeletal Diseases • Nephrology • Oncology • Orthopedics • Renal Disease • FGF23

Characteristics of Mineral Bone Disease Profile in Kidney Transplant Recipients - A 9-Year Retrospective Cohort Study at a Tertiary Center. (PubMed, Transplant Proc) - "Our study showed significant improvements in biochemical bone profile and hemoglobin levels as early as 3 months post-transplant, which had continued to improve or maintain for up to 2 years post-transplant."

Journal • Retrospective data • Chronic Kidney Disease • Musculoskeletal Diseases • Nephrology • Orthopedics • Osteoporosis • Rheumatology • Transplantation

Sucroferric oxyhydroxide monotherapy for hyperphosphatemia in Indian chronic kidney disease patients undergoing hemodialysis: A phase IV, single-arm, open-label study. (PubMed, World J Nephrol) - "This first real-world study in Indian CKD patients on hemodialysis shows SO as a safe, and effective monotherapy for HP, though its small sample size limits generalizability."

Clinical • Journal • Monotherapy • P4 data • Cardiovascular • Chronic Kidney Disease • Endocrine Disorders • Infectious Disease • Metabolic Disorders • Nephrology • Pain • Renal Disease • Secondary Hyperparathyroidism

Integrative Analysis of Drug Co-Prescriptions in Peritoneal Dialysis Reveals Molecular Targets and Novel Strategies for Intervention. (PubMed, J Clin Med) - " We found commonly prescribed drugs such as furosemide, sucroferric oxyhydroxide, calcitriol, darbepoetin alfa, and aluminum hydroxide to be integral components of PD patient management, prescribed in over 30% of PD patients. The molecular-network-based approach found combinations of drugs like theophylline, fluoxetine, celecoxib, and amitriptyline to possibly have synergistic effects and to target dysregulated molecules of PD-related pathomechanisms. Two further distinct categories of drugs emerged as particularly interesting in our study: selective serotonin reuptake inhibitors (SSRIs), which were found to modulate molecules implicated in peritoneal fibrosis, and vascular endothelial growth factor (VEGF) inhibitors, which exhibit anti-fibrotic properties that are potentially useful for PD. This comprehensive exploration of drug co-prescriptions in the context of PD-related pathomechanisms provides valuable insights for opening future therapeutic strategies and..."

Journal • Fibrosis • Immunology • Renal Disease

Management of Resistant Hyperphosphatemia in Maintenance Hemodialysis (MHD) patients - Role of Sucroferric Oxyhydroxide (SFO): A prospective study (ERA 2025) - "Background and Aims:Hyperphosphatemia is common in advanced CKD and is associated with increased cardiovascular morbidity, bone mineral abnormalities and mortality. SFO demonstrated superior efficacy in reducing serum phosphorus levels in MHD patients who previously failed to achieve phosphorus control with sevelamer carbonate in tolerated doses. SFO offered a better phosphorus control (p = 0.03), numerically lower mean daily pill burden (p = 0.02), lower treatment cost and a better treatment adherence than sevelamer carbonate. These findings strongly support the use of SFO as first line hyperphosphatemic patients with advanced CKD to improve phosphorus control, patient longevity and Quality of life."

Clinical • Cardiovascular • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease

Indirect evaluation of bone metabolism in dialysis: do we all have the same bones? (ERA 2025) - "We analyzed demographic data (Date of birth, gender, blood type), comorbidities (Diabetes, hypertension), dialysis data (type of dialysis technique, dialytic age), blood tests (calcium, phosphate, Parathormone, Vitamin D), therapies (magnesium aluminate, calcium carbonate, sevelamer, sucroferric oxyhydroxide, lantanium carbonate, cholecalciferol, calcitriol, paracalcitol, cinacalcet, etelcalcetide) and fractures. In our analysis, we did not find any differences among the treatments for CKD-MBD to which the patients were subjected during the observed period. Our data suggest that, although preclinical studies and early stages of CKD showed that ADPKD patients exhibit distinct bone mineral disorders, no differences in treatment are observed in dialysis patients. Our data even confirm that there is no difference in fracture risk among hemodialysis patients."

Autosomal Dominant Polycystic Kidney Disease • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Genetic Disorders • Hypertension • Metabolic Disorders • Musculoskeletal Diseases • Nephrology • Orthopedics • Polycystic Kidney Disease • Renal Disease

Tenapanor administration combined with phosphate binders provides synergistic phosphate lowering effect (ERA 2025) - "Six types of P binders had been used in Group Ad (sevelamer hydrochloride, bixalomer, calcium carbonate, ferric citrate, sucroferric oxyhydroxide hydrate and lanthanum carbonate hydrate). Oral administration of tenapanor significantly reduced P adsorption and improved serum P level in patients undergoing HD either when it was administrated alone or adding on P binders. This P absorption reduction effect of tenapanor was greatly enhanced when it was added on P binders. The mechanism of this synergistic effect would be an important research question."

Metabolic Disorders • Nephrology • Renal Disease

Comparison of the efficacy of sucroferric oxyhydroxide and lanthanum carbonate in the hyperphosphatemia of maintainable Hemodialysis. (PubMed, BMC Pharmacol Toxicol) - "SFOH was superior to LC in lowering patients' blood phosphorus and iPTH levels in patients with maintenance hemodialysis hyperphosphatemia combined with secondary hyperparathyroidism."

Journal • Endocrine Disorders • Metabolic Disorders • Nephrology • Renal Disease • Secondary Hyperparathyroidism

Ferric Carboxymaltose Versus Iron Sucrose for Treating Anemia in Pregnant Women (clinicaltrials.gov) - P4 | N=60 | Completed | Sponsor: CMH Multan Institute of Medical Sciences

New P4 trial • Anemia • Hematological Disorders

Short- term effect of sucroferric oxyhydroxide on phosphorus reduction in end -stage renal disease patients with hyperphosphatemia (ChiCTR) - P=N/A | N=61 | Completed | Sponsor: Ningbo First Hospital; Ningbo First Hospital

New trial • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease

Effects of Shape on the Disintegration Time and Friability of Sucroferric Oxyhydroxide-Containing Mini-Tablets. (PubMed, Chem Pharm Bull (Tokyo)) - "A cup depth/diameter of 0.2 was identified as optimal for minimizing the friability of mini-tablets and can be implemented in commercial production without issues. In conclusion, tablet shape should be carefully considered during the development of mini-tablets to ensure low friability."

Journal • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease

Management of serum phosphorus over six months in hemodialysis patients: a comparison of sucroferric oxyhydroxide (SO) monotherapy and tenapanor with other non-SO phosphate binders (NKF-SCM 2025) - "However, the SO group had fewer pills (4.7 pills for SO vs 9.7 pills for +TN group at M6), and less diarrhea during fup (20.4% at bl, 23.9% at fup, p=0.19 for SO group; 21.9% at bl, 33.9% at fup, p=0.01 for +TN group).Conclusion For HD pts with sP > 7 mg/dL despite treatment with non-SO monotherapy, switching to SO monotherapy or adding TN resulted in comparable sP reductions, over 6 months. However, pts on SO monotherapy had less than half the PB pill burden, and lower % of diarrhea, compared to those adding TN."

Clinical • Monotherapy • Metabolic Disorders • Nephrology • Renal Disease

Efficacy and Safety of Phosphate-Lowering Agents for Adult Patients with Chronic Kidney Disease Requiring Dialysis: A Network Meta-Analysis. (PubMed, Clin J Am Soc Nephrol) - "Compared with calcium-based agents, sevelamer was associated with lower all-cause mortality, and sucroferric oxyhydroxide and lanthanum were associated with slower progression of CACS. Potential benefits and harms should be considered when selecting phosphate-lowering agents (PROSPERO: CRD42022328388)."

Journal • Retrospective data • Cardiovascular • Chronic Kidney Disease • Gastrointestinal Disorder • Musculoskeletal Diseases • Nephrology • Renal Disease

All That Opaques is Not Metal (ACG 2024) - "Pathologic evaluation concluded them to be pills, and an investigation of his prescribed medications determined them to be Sucroferric oxyhydroxide (Velphoro). Although these pills are less than 2.5 cm, if they have been present for several days, endoscopic evaluation may be necessary to assess the surrounding erosive mucosal damage. Other compounds that can be radiopaque include certain potassium preparations, calcium carbonate, iodinated compounds, acetazolamide, and busulfan, among others."

Back Pain • Gastrointestinal Disorder • Metabolic Disorders • Musculoskeletal Pain • Nephrology • Pain • Renal Disease

In Vitro Study on Combined Effect of Drugs for Hyperphosphatemia on Phosphorus Adsorption Capacity. (PubMed, Chem Pharm Bull (Tokyo)) - "Precipitated calcium carbonate (CC), ferric citrate hydrate (FC), lanthanum carbonate hydrate (LC), and sucroferric oxyhydroxide (SO) were used as phosphorus binders. In contrast, the adsorption capacities of CC + FC and FC + LC decreased in the 1st and 2nd fluid compared with that when used alone because of the release of citrate ions that chelate calcium or lanthanum ions. These results suggest that SO is less affected by interactions with other phosphorus binders and changes in pH and may be suitable for patients receiving concomitant drugs."

Journal • Preclinical • Metabolic Disorders • Nephrology • Renal Disease

Colon Collectibles: Unearthing Coin-Shaped Treasures in Kidney Disease (KIDNEY WEEK 2024) - "Due to its insoluble iron content, unchewed sucroferric oxyhydroxide tablets appear as highly radio-opaque round objects on imaging. Understanding the properties and absorption mechanisms of such medications, coupled with thorough patient history-taking, can mitigate the need for invasive interventions and guide appropriate management strategies."

Nephrology • Renal Disease

A Postmarketing Study Assessing Safety and Efficacy of Velphoro in Korean Adult Dialysis Patients (KIDNEY WEEK 2024) - "In this PMS, GI disorders were the main ADR. No obvious iron accumulation was observed. In conclusion, Velphoro® has a favourable safety and tolerability profile in Korean patients that is consistent with that observed in Phase 3 trial (PA-CL-05A)."

Clinical • P4 data • Chronic Kidney Disease • Gastroenterology • Gastrointestinal Disorder • Metabolic Disorders • Nephrology • Pain

Managing Hyperphosphatemia in Patients on Hemodialysis: A Comparison of Sucroferric Oxyhydroxide (SO) Monotherapy and Tenapanor with Other Non-SO Phosphate Binders (KIDNEY WEEK 2024) - "For HD pts who had sP > 7 mg/dL despite treatment with non-SO monotherapy, switching to SO monotherapy or adding TN resulted in comparable reductions in sP. However, pts with SO monotherapy had less than half the PB pill burden, compared to those adding TN."

Clinical • Monotherapy • Metabolic Disorders • Nephrology • Renal Disease

Efficacy and safety of sucroferric oxyhydroxide versus sevelamer carbonate: A systematic review and meta-analysis. (PubMed, Hemodial Int) - "This meta-analysis of randomized trials showed that both drugs, sucroferric oxyhydroxide and sevelamer equally and effectively controlled serum phosphorus levels, whereas sucroferric oxyhydroxide revealed a better profile in terms of gastrointestinal adverse events. Sucroferric oxyhydroxide is a valuable option for patients receiving KRT when sevelamer carbonate is more difficult to tolerate."

Clinical • Journal • Retrospective data • Review • Chronic Kidney Disease • Gastrointestinal Disorder • Nephrology • Orthopedics • Renal Disease

A Multicenter, Real-world Study of Sucroferric Oxyhydroxide (Velphoro) to Treat Hyperphosphatemia in Chinese Adult CKD Patients on Dialysis (ChiCTR) - P=N/A | N=10000 | Not yet recruiting | Sponsor: Zhongshan Hospital, Fudan University; Zhongshan Hospital, Fudan University

New trial • Real-world • Real-world evidence • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease • FGF23