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. 2021 Feb 1;14(2):681-687.
doi: 10.1093/ckj/sfaa226. eCollection 2021 Feb.

Real-world management of hyperphosphataemia with sucroferric oxyhydroxide: the VELREAL multicentre study

Juan F Navarro-González  1   2   3   4 , María Dolores Arenas  5 , Fernando Henríquez-Palop  6 , María Jesús Lloret  7 , Pablo Molina  8 , Francisco Ríos Moreno  9 , María Asunción Macia-Lagier  10 , Laura Espinel  11 , Emilio Sánchez  12 , Mar Lago  13 , Antonio Crespo  14 , Jordi Bover  3   7
Affiliations

Real-world management of hyperphosphataemia with sucroferric oxyhydroxide: the VELREAL multicentre study

Juan F Navarro-González et al. Clin Kidney J. .

Abstract

Background: The efficacy and safety of sucroferric oxyhydroxide (SO) have been reported in clinical trials. However, real-life data are scarce. This study presents data on the use, efficacy and safety of SO in real clinical practice.

Methods: We performed a retrospective multicentre study, without any influence on the prescription decisions, that included 220 patients from 11 Spanish centres. Demographic, treatment, analytical and nutritional parameters and adherence, side effects and dropout rates were collected during 6 months.

Results: SO was initiated due to inadequate control of serum phosphate (P) in 70% of participants and in 24.5% to reduce the number of tablets. Monotherapy with SO increased from 44% to 74.1%, with a reduction in the average daily number of sachets/tablets from six to two. Serum P decreased by 20% (4.6 ± 1.2 versus 5.8 ± 1.3 mg/dL; P < 0.001), with a significant reduction in intact parathyroid hormone levels (P < 0.01). The percentage of patients with adequate serum P control at threshold levels of 5 and 4.5 mg/dL increased by 45.4% and 35.9%, respectively. Serum ferritin was not modified, while the transferrin saturation index increased significantly (P = 0.04). Serum albumin and normalized protein catabolic rate, when normalized by serum P, increased, averaging 37% and 39%, respectively (P < 0.001). Adherent patients increased from 28.2% to 52.7%. Adverse effects were reported by 14.1% of participants, with abandonment of treatment in 9.5%.

Conclusions: The use of SO in real-life results in better control of serum P, a reduction in the number of tablets and an improvement in therapeutic adherence. In addition, it may be beneficial with regards to secondary hyperparathyroidism and nutritional status.

Keywords: haemodialysis; hyperphosphataemia; nutritional status; sucorferric oxyhydroxide; therapeutic adherence.

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Figures

FIGURE 1:
FIGURE 1:
Distribution of patients according to the number of tablets/sachets of P binders at the beginning and end of the study and the percentage of monotherapy cases at baseline and at the end of the study.
FIGURE 2:
FIGURE 2:
Variation in therapeutic adherence and in the percentage of patients with a serum P concentration <5 mg/dL and <4.5 mg/dL.
See this image and copyright information in PMC

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