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Lanthanum carbonate.

Tracy Swainston Harrison1, Lesley J Scott

  • 1Adis International Limited, 41 Centorian Drive, Mairangi Bay, Auckland 1311, New Zealand. demail@adis.co.nz

Drugs
|April 23, 2004
PubMed
Summary

Lanthanum carbonate effectively lowers serum phosphorus in dialysis patients. It is well-tolerated, showing similar safety to other phosphate binders but with fewer hypercalcemic episodes.

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Area of Science:

  • Nephrology
  • Pharmacology
  • Biochemistry

Background:

  • Hyperphosphatemia is a common complication in patients with chronic renal failure undergoing hemodialysis.
  • Phosphate binders are essential for managing serum phosphorus levels in these patients.
  • Lanthanum carbonate offers a novel, non-aluminum, non-calcium-based phosphate binding option.

Purpose of the Study:

  • To evaluate the efficacy and safety of lanthanum carbonate in reducing and maintaining serum phosphorus levels in patients with chronic renal failure on hemodialysis.
  • To compare the effectiveness and tolerability of lanthanum carbonate against placebo and conventional phosphate binders, including calcium carbonate.

Main Methods:

  • Two randomized, double-blind, multicenter 4-week trials comparing lanthanum carbonate to placebo.
  • Two large randomized trials comparing lanthanum carbonate to calcium carbonate and/or other conventional phosphate binders over 6 months and 2 years.
  • A randomized 1-year trial assessing renal bone disease in patients treated with lanthanum carbonate versus calcium carbonate.

Main Results:

  • Lanthanum carbonate significantly reduced serum phosphorus levels compared to placebo.
  • Lanthanum carbonate demonstrated comparable efficacy to calcium carbonate and other binders in reducing and maintaining serum phosphorus levels (< or =5.6 mg/dL over 6 months and < or =5.9 mg/dL over 2 years).
  • Adverse events were generally mild-to-moderate, with gastrointestinal events being most common. Hypercalcemic episodes were significantly less frequent with lanthanum carbonate than with calcium carbonate over 6 months.
  • Fewer patients on lanthanum carbonate showed signs of renal bone disease at study end compared to baseline in a 1-year trial, unlike the calcium carbonate group.

Conclusions:

  • Lanthanum carbonate is an effective phosphate binder for patients with chronic renal failure on hemodialysis.
  • Lanthanum carbonate exhibits a favorable tolerability profile, with a lower incidence of hypercalcemia compared to calcium carbonate.
  • Lanthanum carbonate may have a beneficial effect on renal bone disease progression.

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