Lanthanum carbonate: a new phosphate binder.

Area of Science:

• Nephrology
• Pharmacology
• Biochemistry

Background:

• Hyperphosphatemia is a significant complication in end-stage renal disease (ESRD) management.
• Efficient and well-tolerated phosphate binders are crucial for ESRD patients.
• Lanthanum carbonate presents a novel therapeutic option.

Purpose of the Study:

• To review the efficacy and safety of lanthanum carbonate as a phosphate binder.
• To compare lanthanum carbonate with existing phosphate binders.
• To evaluate the long-term effects of lanthanum carbonate, including tissue deposition and bone health.

Main Methods:

• Review of preclinical and clinical studies on lanthanum carbonate.
• Analysis of human efficacy and safety data up to 3 years.
• Evaluation of long-term (up to 4 years) bone lanthanum levels and effects on mineralization.
• Comparison with calcium carbonate in a randomized, controlled study.

Main Results:

• Lanthanum carbonate is an effective and well-tolerated phosphate binder in clinical studies.
• Adverse effects are primarily gastrointestinal and comparable to calcium carbonate.
• Lanthanum absorption is minimal, with low renal excretion.
• Long-term bone lanthanum deposition did not impair mineralization or osteoblast function.
• Lanthanum distribution in bone differs from aluminum and does not induce low bone turnover.

Conclusions:

• Lanthanum carbonate demonstrates potent phosphate-binding capabilities.
• It is minimally absorbed from the gastrointestinal tract.
• The drug exhibits an encouraging safety profile with no deleterious effects on bone.