Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (<scp><b>AMBER</b></scp>): results in the pre‐specified subgroup with heart failure

Rossignol, Patrick; Williams, Bryan; Mayo, Martha; Warren, Suzette; Arthur, Susan; Ackourey, Gail; White, William Β.; Agarwal, Rajiv

doi:10.1002/ejhf.1860

Cited by 33 publications

(33 citation statements)

References 26 publications

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“…Data on the use of ACEi/ARB therapy in OPAL HK was reported separately. For two studies with Patiromer (AMBER and OPAL HK), we extracted data from publications on subgroups with heart failure [ 20 , 21 ] ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Patiromer: The most common adverse events were gastrointestinal disorders (12/56 PEARL HF, 9/105 AMETHYST-DN, 5/27 OPAL and 7/63, Rossignol et al, 2020), and hypomagnesemia (13/56 PEARL HF, 19/105 AMETHYST-DN, 3/102 OPAL, and 2/63 Rossignol et al, 2020) [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

“…We identified 12 studies randomizing 2800 adult participants evaluating potassium binders for chronic HK (defined as >5 mmol/L). Data for efficacy outcomes included in this review were available in four of these twelve studies: three for MRA therapy (PRIORITIZE HF [ 30 ], PEARL HF [ 29 ], and Rossignol et al, 2020 [ 21 ]) and only one for ACEi/ARB therapy (OPAL HK [ 32 ]). In the safety analysis, we included six studies (PRIORITIZE HF [ 30 ], HARMONIZE [ 34 ], PEARL HF [ 29 ], Rossignol et al, 2020 [ 21 ], OPAL HK [ 32 ], and AMETHYST-DN [ 24 ]).…”

Section: Discussionmentioning

confidence: 99%

“…Data for efficacy outcomes included in this review were available in four of these twelve studies: three for MRA therapy (PRIORITIZE HF [ 30 ], PEARL HF [ 29 ], and Rossignol et al, 2020 [ 21 ]) and only one for ACEi/ARB therapy (OPAL HK [ 32 ]). In the safety analysis, we included six studies (PRIORITIZE HF [ 30 ], HARMONIZE [ 34 ], PEARL HF [ 29 ], Rossignol et al, 2020 [ 21 ], OPAL HK [ 32 ], and AMETHYST-DN [ 24 ]). New potassium binders seem to have an effect on MRA optimization (moderate certainty evidence).…”

Section: Discussionmentioning

confidence: 99%

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Optimization of RAASi Therapy with New Potassium Binders for Patients with Heart Failure and Hyperkalemia: Rapid Review and Meta-Analysis

Montagnani

Frasson

Gussoni

et al. 2021

JCM

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(1) Background: The objective of this rapid review is to assess whether new potassium binders (NPBs) could enable the optimization of RAASi therapy more than usual care or placebo in patients with or at risk of heart failure and hyperkalemia. (2) Methods: We searched for RCTs that included patients with or at risk of hyperkalemia and patients treated with Patiromer or sodium zirconium cyclosilicate (ZSC). The comparators were placebo, usual care, and potassium binders with different doses or different treatment protocols. We searched the Cochrane CENTRAL, MEDLINE, and ClinicalTrials.gov databases. The risk of bias was assessed using the Cochrane risk of bias tool for RCTs. Data were pooled using the random effects model, and the fixed effects model was used for sensitivity analysis. (3) Results: We included 12 studies with 2800 enrolled patients. Only three of these trials (412 patients) were included in the meta-analysis. NPBs seemed to have an effect on the optimization of MRA therapy, with an RR (95% CI) of 1.24 (1.09, 1.42) (moderate certainty evidence); Patiromer seemed to have an effect on MRA optimization, with an RR (95% CI) or 1.25 (1.08, 1.45) (high certainty evidence). ZSC seemed to have no effect on enabling MRA therapy, with an RR (95% CI) of 1.19 (0.89, 1.59) (low certainty evidence). The AEs in HF patients with hyperkalemia treated with Patiromer were GI disorders and hypomagnesemia. ZSC The AEs included chronic cardiac failure, hypokalemia, and edema. (4) Conclusions: This meta-analysis included three studies with a small number of patients and a short follow-up period (1–3 months). The evidence of the effect of NPBs on MRA optimization had a moderate certainty for imprecision. Data on the effect on MRA optimization and less severe AEs in long-term treatment seem to suggest the use of Patiromer for the optimization of MRA therapy in patients with or at risk of heart failure and hyperkalemia. Future adequately powered RCTs are needed to assess the benefits and potential harms of potassium binders.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Optimization of RAASi Therapy with New Potassium Binders for Patients with Heart Failure and Hyperkalemia: Rapid Review and Meta-Analysis

Montagnani

Frasson

Gussoni

et al. 2021

JCM

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“…4 Potassiumlowering agent-incorporating neurohormonal blockade therapy in LVAD patients is a strategy that requires further prospective investigation. 16…”

Section: Discussionmentioning

confidence: 99%

Hyperkalemia in Patients With Left Ventricular Assist Devices

et al. 2021

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Patient SelectionConsecutive patients who underwent LVAD implantation at our institution between 2014 and 2018 were retrospectively evaluated for inclusion in the study. All patients under LVAD support were medically treated by the heart failure team, including heart failure cardiologists, cardiac surgeons, and LVAD coordinators. Clinical decision making was made by this multidisciplinary team. Patients without data on serum potassium levels at 1 month after implantation, which was assumed to be the time of discharge, were excluded. In addition, patients who died within 1 month after implantation were excluded.This study was approved by the Institutional Review Board of The University of Chicago (IRB16-0632). Written informed consent was obtained from all participants beforehand. The study was performed in accordance with the Declaration of Helsinki and the ethical standards of the responsible committee on human experimentation. Primary EndpointPatients were stratified into 3 groups based on serum

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Ultrathin Niobium Carbide MXenzyme for Remedying Hypertension by Antioxidative and Neuroprotective Actions

Yang

Xia

et al. 2023

Angewandte Chemie

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Hypertension, as a leading risk factor for cardiovascular diseases, is associated with oxidative stress and impairment of endogenous antioxidant mechanisms, but there is still a tremendous knowledge gap between hypertension treatment and nanomedicines. Herein, we report a specific nanozyme based on ultrathin two‐dimensional (2D) niobium carbide (Nb2C) MXene, termed Nb2C MXenzyme, to fight against hypertension by achieving highly efficient reactive oxygen species elimination and inflammatory factors inhibition. The biocompatible Nb2C MXenzyme displays multiple enzyme‐mimicking activities, involving superoxide dismutase, catalase, glutathione peroxidase, and peroxidase, inducing cytoprotective effects by resisting oxidative stress, thereby alleviating inflammatory response and reducing blood pressure, which is systematically demonstrated in a stress‐induced hypertension rat model. This strategy not only opens new opportunities for nanozymes to treat hypertension but also expands the potential biomedical applications of 2D MXene nanosystems.

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Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): results in the pre‐specified subgroup with heart failure

Cited by 33 publications

References 26 publications

Optimization of RAASi Therapy with New Potassium Binders for Patients with Heart Failure and Hyperkalemia: Rapid Review and Meta-Analysis

Optimization of RAASi Therapy with New Potassium Binders for Patients with Heart Failure and Hyperkalemia: Rapid Review and Meta-Analysis

Hyperkalemia in Patients With Left Ventricular Assist Devices

Ultrathin Niobium Carbide MXenzyme for Remedying Hypertension by Antioxidative and Neuroprotective Actions

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