Effect Of Lanthanum Carbonate vs Calcium Acetate As A Phosphate Binder In Stage 3-4 CKD- ‘Treat To Goal Study’
Journal Title: Stanley Medical Journal - Year 2016, Vol 3, Issue 4
Abstract
Context: Hyperphosphatemia is a common in stage 3-4 CKD and influences the progression and prognosis in CKD patients. The efficacy and tolerability of non-calcium phosphate binders has not been studied in any open-label RCT. This study tried to compare the efficacy of lanthanum carbonate with conventional calcium-based phosphate binders such as calcium acetate. Aim: 1. Compare the efficacy of lanthanum carbonate vs calcium acetate as a phosphate binder 2. Compare the propensity of the above two drugs in producing/preventing hypercalcemia 3. Economic comparison between the two drugs 4. Settings and Design: ‘Treat to Goal’ open-labeled randomized cross-over comparison study Methods and Materials: Seventeen patients were randomized to receive either lanthanum carbonate or calcium acetate for 8 weeks. After a washout period of 2 weeks, patients were crossed to receive alternate drug for 8 weeks. For patients whose phosphorus was still not in target range, combination of the two drugs were given for 8 weeks. Serum calcium, serum phosphorus, Ca X P product and serum creatinine were estimated at frequent intervals. Paired ‘T’ test was used to compare the means of the two groups. Results: In the 15 patients who completed the study both lanthanum and calcium acetate were equally good phosphate binders. Although rise in calcium and Ca X P product was more with calcium acetate, it was not statistically significant. Conclusion: Both lanthanum carbonate and calcium acetate are equally effective phosphate binders and reduce phosphorus levels to a similar extent. Serum calcium and Ca X P products showed a rising trend with calcium acetate but it was not statistically significant. The cost of lanthanum carbonate was 17 times more than that of calcium acetate which is an important consideration in a developing country like ours
Authors and Affiliations
K. S. Sajeev Kumar, Mohandas M K, Ramdas Pisharody, Rakesh S Nair
Keywords
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