Nitta Kosaku
   Department   Other, Other
   Position  
Article types Original article
Language English
Peer review Non peer reviewed
Title Randomized Study of Tenapanor Added to Phosphate Binders for Patients With Refractory Hyperphosphatemia.
Journal Formal name:Kidney international reports
Abbreviation:Kidney Int Rep
ISSN code:24680249/24680249
Volume, Issue, Page 8(11),pp.2243-2253
Author and coauthor Nitta Kosaku, Itoyama Saki, Ikejiri Kazuaki, Kinoshita Jun, Nakanishi Kaoru, Fukagawa Masafumi, Akizawa Tadao
Authorship Lead author
Publication date 2023/11
Summary INTRODUCTION:Serum phosphorus management is important for patients with chronic kidney disease on dialysis to reduce the risk of hyperparathyroidism and ectopic vascular calcification. Phosphate binders (PBs) control serum phosphorus levels; however, some patients do not achieve adequate control with existing PBs. The similar mechanisms of action of each PB may limit their ability to lower serum phosphorus levels. Therefore, drugs with novel mechanisms of action that can be added to existing PBs to further lower serum phosphorus levels are desired. Tenapanor, a novel selective inhibitor of intestinal sodium/hydrogen exchanger 3 transporters, decreases passive phosphate absorption in the intestine, thereby decreasing serum phosphorus levels.METHODS:This study evaluated the efficacy and safety of tenapanor treatment with up-titration when added to PBs among Japanese hemodialysis patients with hyperphosphatemia poorly controlled by PBs alone. In total, 169 patients taking PBs whose serum phosphorus level was ≥6.1 and <10.0 mg/dl initiated the 8-week treatment (placebo + PB, n = 85; tenapanor + PB, n = 84).RESULTS:The least squares mean change from baseline to week 8 in serum phosphorus level was -0.24 and -2.00 mg/dl in the placebo and tenapanor groups, respectively, with a statistically significant difference between groups (-1.76 mg/dl; P < 0.0001). Diarrhea as a treatment-emergent adverse event (TEAE) occurred in 14.1% and 63.1% of patients in the placebo and tenapanor groups, respectively. All diarrhea events were mild or moderate.CONCLUSION:Tenapanor added to PBs improved serum phosphorus levels that could not previously be controlled by PBs alone, and no new safety concerns were raised.
DOI 10.1016/j.ekir.2023.08.003
PMID 38025211