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Design and baseline characteristics of the LANDMARK study

Hiroaki Ogata1, Masafumi Fukagawa2, Hideki Hirakata3

  • 1Department of Internal Medicine, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, Kanagawa, 224-8503, Japan. ogatah@med.showa-u.ac.jp.

Clinical and Experimental Nephrology
|July 14, 2016
PubMed

Insights

Lanthanum carbonate (LC) may reduce cardiovascular events in hemodialysis patients compared to calcium carbonate (CC). The LANDMARK study investigates this potential benefit, evaluating patient survival free from cardiovascular events.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Calcium-based phosphate binders are linked to vascular calcification and cardiovascular events in hemodialysis patients.
  • Non-calcium-based binders offer an alternative to mitigate these risks.

Purpose of the Study:

  • To determine if lanthanum carbonate (LC), a non-calcium-based phosphate binder, reduces cardiovascular mortality and morbidity.
  • To compare the efficacy of LC versus calcium carbonate (CC) in chronic hemodialysis patients.

Main Methods:

  • The LANDMARK study is a randomized, open-label, comparative trial involving 2309 hemodialysis patients.
  • Patients were assigned to receive either lanthanum carbonate (LC) or calcium carbonate (CC) with dose titration to achieve target serum phosphorus levels.
  • The primary endpoint was survival time free of major cardiovascular events.

Main Results:

  • Baseline characteristics were well-balanced between the 1154 patients in the LC group and 1155 patients in the CC group.
  • The study included a significant proportion of elderly patients (mean age 68.4 years) with comorbidities like diabetes (55.9%).

Conclusions:

  • The LANDMARK study is designed to provide crucial data on the cardiovascular safety and efficacy of lanthanum carbonate in hemodialysis.
  • Results will inform clinical practice regarding phosphate binder selection to improve cardiovascular outcomes.
Abstract

Keywords:
CalciumCardiovascular eventHemodialysisPhosphate binderRandomized controlled trial

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