Comparison of Dietary Phosphate Absorption After Single Doses of Lanthanum Carbonate and Sevelamer Carbonate in Healthy Volunteers: A Balance Study

Martin, Patrick; Wang, Phillip; Robinson, Antoine; Poole, Lynne; Dragone, Jeffrey; Smyth, Michael; Pratt, Raymond D.

doi:10.1053/j.ajkd.2010.11.028

Cited by 43 publications

(37 citation statements)

References 23 publications

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“…These data suggest that lanthanum carbonate possesses high phosphorus-binding efficacy with low tablet burden. A single-dose balance study in healthy volunteers by Martin et al [25] supports our results in that 1000 mg of lanthanum carbonate could decrease serum phosphate by 45% compared with a 21% decrease with 2400 mg of sevelamer carbonate. Daugirdas et al [26] further calculated the phosphate binder equivalent doses.…”

Section: Discussionsupporting

confidence: 89%

Lanthanum carbonate for the treatment of hyperphosphatemia in CKD 5D: multicenter, double blind, randomized, controlled trial in mainland China

Zhang

et al. 2013

BMC Nephrol

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BackgroundSerum phosphorus control is critical for chronic kidney disease (CKD) 5D patients. Currently, clinical profile for an oral phosphorus binder in the mainland Chinese population is not available.ObjectiveTo establish the efficacy, safety, and tolerability of lanthanum carbonate in CKD 5D patients.DesignMulticenter, randomized, double blind, placebo-controlled study. A central randomization center used computer generated tables to allocate treatments.SettingTwelve tertiary teaching hospitals and medical university affiliated hospitals in mainland China.ParticipantsOverall, 258 hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) adult patients were enrolled.InterventionAfter a 0–3-week washout period and a 4-week lanthanum carbonate dose-titration period, 230 patients were randomized 1:1 to receive lanthanum carbonate (1500 mg-3000 mg) or placebo for a further 4-week maintenance phase.Main outcome measuresEfficacy and safety of lanthanum carbonate to achieve and maintain target serum phosphorus concentrations were assessed.ResultsIn the titration phase, serum phosphorus concentrations of all patients decreased significantly. About three-fifths achieved target levels without significantly disturbing serum calcium levels. At the end of the maintenance period, the mean difference in serum phosphorus was significantly different between the lanthanum carbonate and placebo-treated groups (0.63±0.62 mmol/L vs. 0.15±0.52 mmol/L, P < 0.001). The drug-related adverse effects were mild and mostly gastrointestinal in nature.ConclusionLanthanum carbonate is an efficacious and well-tolerated oral phosphate binder with a mild AE profile in hemodialysis and CAPD patients. This agent may provide an alternative for the treatment of hyperphosphatemia in CKD 5D patients in mainland China.Trial registrationNo. ChiCTR-TRC-10000817

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Section: Discussionsupporting

confidence: 89%

Lanthanum carbonate for the treatment of hyperphosphatemia in CKD 5D: multicenter, double blind, randomized, controlled trial in mainland China

Zhang

et al. 2013

BMC Nephrol

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“…The findings of the experimental study were confirmed in a one-dose, one-meal balance study in which healthy human volunteers received a single, clinically relevant dose of lanthanum (1,000 mg) or sevelamer (2,400 mg) (15). These doses were chosen to reflect common doses used in the clinic.…”

Section: Experimental Studymentioning

confidence: 65%

“…Statistical analysis was performed using SAS (version 9.2) using a standard mixed-effect linear model (15) with adjustment for group sequence, period, and treatment as fixed effects; subject within sequence was included as a random effect.…”

Section: Discussionmentioning

confidence: 99%

“…In the clinical study, which was initially set up to evaluate the phosphate-binding efficacy of lanthanum carbonate versus sevelamer (15), calcium balance was also determined. In brief, 31 volunteers (age: 19 -45 yr) with normal renal function were randomized to one of six treatment sequences, each consisting of four treatment periods separated by a 7-to 14-day washout.…”

Section: Clinical Studymentioning

confidence: 99%

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Differences in gastrointestinal calcium absorption after the ingestion of calcium-free phosphate binders

Behets

Dams

Damment

et al. 2014

American Journal of Physiology-Renal Physiology

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Both calcium-containing and noncalcium-containing phosphate binders can increase gastrointestinal calcium absorption. Previously, we observed that lanthanum carbonate administration to rats with renal failure is not associated with increased calciuria. Additionally, lanthanum carbonate treatment in dialysis patients has been associated with a less pronounced initial decrease in serum parathyroid hormone compared with other phosphate binders. For 8 days, male Wistar rats received a diet supplemented with 2% lanthanum carbonate, 2% sevelamer, 2% calcium carbonate, or 2% cellulose. Calciuria was found to be increased in animals with normal renal function treated with sevelamer or calcium carbonate but not with lanthanum carbonate. In animals with renal failure, cumulative calcium excretion showed similar results. In rats with normal renal function, serum ionized calcium levels were increased after 2 days of treatment with sevelamer, while calcium carbonate showed a smaller increase. Lanthanum carbonate did not induce differences. In animals with renal failure, no differences were found between sevelamer-treated, calcium carbonate-treated, and control groups. Lanthanum carbonate, however, induced lower ionized calcium levels within 2 days of treatment. These results were confirmed in normal human volunteers, who showed lower net calcium absorption after a single dose of lanthanum carbonate compared with sevelamer carbonate. In conclusion, these two noncalcium-containing phosphate-binding agents showed a differential effect on gastrointestinal calcium absorption. These findings may help to improve the management of calcium balance in patients with renal failure, including concomitant use of vitamin D.

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“…Phosphate binders can provide the patient with greater nutritional freedom. However, different types of binders have different phosphate binding capacities; for example, in one study, lanthanum carbonate bound 135 mg phosphate per tablet, whereas sevelamer carbonate bound 21 mg phosphate per tablet [24]. Different phosphate binders are, therefore, associated with varying pill burden (Table 1) [25-31].…”

Section: Reviewmentioning

confidence: 99%

Hyperphosphatemia in patients with ESRD: assessing the current evidence linking outcomes with treatment adherence

Covic

Rastogi

2013

BMC Nephrol

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In recent years, the imbalance in phosphate homeostasis in patients with end-stage renal disease (ESRD) has been the subject of much research. It appears that, while hyperphosphatemia may be a tangible indicator of deteriorating kidney function, lack of phosphate homeostasis may also be associated with the increased risk of cardiovascular events and mortality that has become a hallmark of ESRD. The need to maintain phosphorus concentrations within a recommended range is reflected in evidence-based guidelines. However, these do not reflect serum phosphorus concentrations achieved by most patients in clinical practice. Given this discrepancy, it is important to consider ways in which dietary restriction of phosphorus intake and, in particular, use of phosphate binders in patients with ESRD can be made more effective. Poor adherence is common in patients with ESRD and has been associated with inadequate control of serum phosphorus concentrations. Studies indicate that, among other factors, major reasons for poor adherence to phosphate binder therapy include high pill burden and patients’ lack of understanding of their condition and its treatment. This review examines available evidence, seeking to understand fully the reasons underlying poor adherence in patients with ESRD and consider possible strategies for improving adherence in clinical practice.

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Comparison of Dietary Phosphate Absorption After Single Doses of Lanthanum Carbonate and Sevelamer Carbonate in Healthy Volunteers: A Balance Study

Cited by 43 publications

References 23 publications

Lanthanum carbonate for the treatment of hyperphosphatemia in CKD 5D: multicenter, double blind, randomized, controlled trial in mainland China

Lanthanum carbonate for the treatment of hyperphosphatemia in CKD 5D: multicenter, double blind, randomized, controlled trial in mainland China

Differences in gastrointestinal calcium absorption after the ingestion of calcium-free phosphate binders

Hyperphosphatemia in patients with ESRD: assessing the current evidence linking outcomes with treatment adherence

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