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Real-World Phosphate Binder Use among Dialysis-Dependent Patients with CKD
Todd Berner1, Christine Ferro2, Gabriela Dieguez2
1Research and Development, Akebia Therapeutics Inc., Cambridge, Massachusetts, USA.
Nephron
|March 30, 2023
Summary
Phosphate binder use in dialysis-dependent chronic kidney disease (CKD) patients showed low adherence and persistence. Ferric citrate, sucroferric oxyhydroxide, and lanthanum carbonate experienced net positive switching.
Area of Science:
- Nephrology
- Pharmacology
- Real-world evidence
Background:
- Phosphate binder (PB) treatment is crucial for dialysis-dependent chronic kidney disease (DD-CKD) patients.
- Understanding PB utilization and switching patterns is essential for optimizing patient care.
Purpose of the Study:
- To assess real-world phosphate binder utilization and switching rates.
- To evaluate adherence and persistence across different phosphate binders in DD-CKD patients.
Main Methods:
- Retrospective analysis of 2018-2019 Medicare data for DD-CKD patients using phosphate binders.
- Patients categorized by primary phosphate binder: calcium acetate, ferric citrate, lanthanum carbonate, sevelamer, sucroferric oxyhydroxide.
- Adherence (proportion of days covered >80%) and persistence (PB use in last 90 days) measured. Net switching rates calculated.
Main Results:
- 136,912 patients with PB use identified.
- Adherence rates ranged from 63.8% to 67.7%; persistence from 85.1% to 89.5%.
- Ferric citrate, sucroferric oxyhydroxide, and lanthanum carbonate showed positive net switching rates (2-10%), while sevelamer and calcium acetate showed negative rates (-2% to -7%).
Conclusions:
- Phosphate binder adherence and persistence rates were generally low across agents.
- Certain phosphate binders (ferric citrate, sucroferric oxyhydroxide, lanthanum carbonate) experienced net positive switching.
- Further research is needed to understand switching drivers and improve phosphate level control in CKD patients.
Keywords:
AdherenceDialysis-dependent chronic kidney diseaseHyperphosphatemiaPersistencePhosphate binderMore Related Videos
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