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Lanthanum carbonate delays progression of coronary artery calcification compared with calcium-based phosphate binders

Takayasu Ohtake1, Shuzo Kobayashi, Machiko Oka

  • 1Department of Nephrology, Immunology, and Vascular Medicine, Shonan Kamakura General Hospital, Kamakura, Japan. ohtake@shonankamakura.or.jp

Journal of Cardiovascular Pharmacology and Therapeutics
|April 26, 2013
PubMed

Insights

Switching hemodialysis patients from calcium carbonate to lanthanum carbonate binders significantly slowed coronary artery calcification progression. This suggests lanthanum carbonate may be a better option for managing cardiovascular risk in this population.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Coronary artery calcification (CAC) is a significant risk factor for cardiovascular events and mortality in patients undergoing hemodialysis (HD).
  • Calcium-based phosphate binders are commonly used but may contribute to CAC progression.

Purpose of the Study:

  • To investigate if switching from calcium carbonate (CC) to lanthanum carbonate (LC) can delay the progression of CAC in patients on HD.
  • To compare the effects of LC versus CC on CAC progression over a 6-month period.

Main Methods:

  • A pilot study involving 52 patients on HD was conducted.
  • Patients were initially treated with CC for 6 months, during which CAC scores were measured.
  • Patients were then randomized to receive either CC or LC for another 6 months, with repeat CAC score evaluations.

Main Results:

  • All patients showed significant CAC progression during the initial 6 months on CC.
  • Over the subsequent 6 months, the group treated with lanthanum carbonate (LC) demonstrated significantly less progression of CAC compared to the calcium carbonate (CC) group.
  • Percentage changes in CAC scores were significantly lower in the LC group (-6.4%) versus the CC group (41.2%).
  • Serum calcium, phosphate, and iPTH levels remained comparable between the groups.

Conclusions:

  • Lanthanum carbonate (LC) appears to delay the progression of coronary artery calcification in patients on hemodialysis (HD) when compared to calcium carbonate (CC).
  • This finding suggests a potential benefit of LC in mitigating cardiovascular risk in HD patients.
Abstract

Keywords:
calcium carbonatecoronary artery calcificationhemodialysislanthanumphosphate binder

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