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Editorial
. 2020 Nov;8(22):1539.
doi: 10.21037/atm-20-3320.

Veverimer for treatment of chronic metabolic acidosis in patients with chronic kidney disease

Anirudh R Gone  1 , Wei Chen  1   2
Affiliations
Editorial

Veverimer for treatment of chronic metabolic acidosis in patients with chronic kidney disease

Anirudh R Gone et al. Ann Transl Med. 2020 Nov.
No abstract available

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Conflict of interest statement

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-3320). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Summary of the veverimer studies to treat chronic metabolic acidosis in CKD. Veverimer is a nonabsorbable hydrochloric acid binder. After ingestion, veverimer is protonated and binds to chloride anions, thus reducing the amount of hydrochloric acid in the gastrointestinal tract. To study the efficacy and safety of veverimer, 217 patients with moderate to severe CKD (eGFR between 20 and 40 mL/min per 1.73 m2) and serum bicarbonate concentration between 12 and 20 mEq/L were randomized to receive either veverimer or placebo for 12 weeks; then 196 continued on their blinded treatment assignment for another 40 weeks. Veverimer was well tolerated with no serious adverse events, except short-term gastrointestinal side effects such as diarrhea. Compared to placebo, veverimer effectively increased serum bicarbonate level. Serum bicarbonate levels started to increase after 1 week of veverimer. At week 4, serum bicarbonate increased by ~4 mEq/L in average and this increase was sustained for the remaining 48 weeks of veverimer treatment. Veverimer improved physical function after 52 weeks, which were measured subjectively measured by KDQoL-PFD survey and objectively by repeated chair-stand test. Lastly, treatment with veverimer was associated with improved time to the composite clinical endpoint of death, initiation of renal replacement therapy or having ≥50% reduction in eGFR. CKD, chronic kidney disease; KDQoL-PFD, physical function domain of Kidney Disease and Quality of Life; eGFR, estimated glomerular filtrate rate.
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Comment on

References

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