Novel treatment strategies to manage potassium in Heart Failure - - PowerPoint PPT Presentation

▶
novel treatment strategies to manage potassium in heart
SMART_READER_LITE
LIVE PREVIEW

Novel treatment strategies to manage potassium in Heart Failure - - PowerPoint PPT Presentation

Oct 10, 2023 239 likes •460 views

Potassium binding drugs Novel treatment strategies to manage potassium in Heart Failure Peter van der Meer, MD PhD FESC cardiologist University Medical Center Groningen The Netherlands University Medical Center Groningen Potassium binding

slide-1
SLIDE 1

Potassium binding drugs

University Medical Center Groningen

Novel treatment strategies to manage potassium in Heart Failure

Peter van der Meer, MD PhD FESC cardiologist

University Medical Center Groningen The Netherlands

slide-2
SLIDE 2

Potassium binding drugs

University Medical Center Groningen

Therapeutic options for Hyperkalemia

  • Acute therapies:
  • insulin, beta-adrenergic agonist (nebulized), sodium

bicarbonate)

  • Dialysis (invasive and expensive)

Chronic therapies

slide-3
SLIDE 3

Potassium binding drugs

University Medical Center Groningen

slide-4
SLIDE 4

Potassium binding drugs

University Medical Center Groningen

Given the non-selective binding and side effects, there is a clinical need for hyperkalemia treatment that is effective, safe and well-tolerated 2 novel potassium binders:

  • Patiromer
  • ZS-9
slide-5
SLIDE 5

Potassium binding drugs

University Medical Center Groningen

Patiromer

slide-6
SLIDE 6

Potassium binding drugs

University Medical Center Groningen

  • Effect of patiromer on serum potassium
  • Diabetes (type 2), N=306
  • eGFR 15-60 ml/min
  • RAASi
  • Potassium > 5 mmol/L
  • Endpoint: Efficacy: Change in K+ (baseline – week 4)

Safety: adverse events during 1 year FU

slide-7
SLIDE 7

Potassium binding drugs

University Medical Center Groningen

NB: no placebo group

slide-8
SLIDE 8

Potassium binding drugs

University Medical Center Groningen

  • N=104, chronic HF
  • History of Hyper K+
  • CKD: GFR<60 ml/min/1.73m2
  • Patiromer vs Placebo
  • Efficacy Endpoint: change in potassium
  • Safety endpoint: AE
slide-9
SLIDE 9

Potassium binding drugs

University Medical Center Groningen

Efficacy

slide-10
SLIDE 10

Potassium binding drugs

University Medical Center Groningen

Safety

slide-11
SLIDE 11

Potassium binding drugs

University Medical Center Groningen

Van der Meer et al. Eur Heart J 2011

slide-12
SLIDE 12

Potassium binding drugs

University Medical Center Groningen

ZS-9

slide-13
SLIDE 13

Potassium binding drugs

University Medical Center Groningen

  • N=753
  • K+ 5.0-6.5
  • Endpoint: change K+
slide-14
SLIDE 14

Potassium binding drugs

University Medical Center Groningen

Effect of ZS-9 in the first 48 hrs

slide-15
SLIDE 15

Potassium binding drugs

University Medical Center Groningen

slide-16
SLIDE 16

Potassium binding drugs

University Medical Center Groningen

Safety profile

slide-17
SLIDE 17

Potassium binding drugs

University Medical Center Groningen

Eur J Heart Fail 2015

Subgroup analysis HF patients

  • N=94
  • Reported HF
  • Effect on Potassium
  • AE in this subgroup
slide-18
SLIDE 18

Potassium binding drugs

University Medical Center Groningen

Efficacy

Early phase – open label Randomized fase (double-blind-placebo)

slide-19
SLIDE 19

Potassium binding drugs

University Medical Center Groningen

Efficacy of the 4 groups

slide-20
SLIDE 20

Potassium binding drugs

University Medical Center Groningen

Safety profile

SA in >1 patient reported

slide-21
SLIDE 21

Potassium binding drugs

University Medical Center Groningen

Conclusions

  • Older potassium binding agents lead to serious side effects
  • Novel K-binding drugs have a favorable safety profile
  • Both drugs are highly effective in lowering potassium
  • Higher dosages of spironolactone can be achieved
  • Whether this results in an improved outcome is unclear