Efficacy and Safety of Sodium Zirconium Cyclosilicate for Treatment of Hyperkalemia: An 11-Month Open-Label Extension of HARMONIZE.

Simon D Roger, Bruce S Spinowitz, Edgar V Lerma, Bhupinder Singh, David K Packham, Ayman Al-Shurbaji, Mikhail Kosiborod

Journal: American journal of nephrology 2020;50(6):473-480

PMID: 31658466

Abstract

BACKGROUND

Sodium zirconium cyclosilicate (SZC; formerly ZS-9) is a selective potassium (K+) binder for treatment of hyperkalemia. An open-label extension (OLE) of the -HARMONIZE study evaluated efficacy and safety of SZC for ≤11 months.

METHODS

Patients from HARMONIZE with point-of-care device i-STAT K+ 3.5-6.2 mmol/L received once-daily SZC 5-10 g for ≤337 days. End points included achievement of mean serum K+ ≤5.1 mmol/L (primary) or ≤5.5 mmol/L (secondary).

RESULTS

Of 123 patients who entered the extension (mean serum K+ 4.8 mmol/L), 79 (64.2%) completed the study. The median daily dose of SZC was 10 g (range 2.5-15 g). The primary end point was achieved by 88.3% of patients, and 100% achieved the secondary end point. SZC was well tolerated with no new safety concerns.

CONCLUSION

In the HARMONIZE OLE, most patients maintained mean serum K+ within the normokalemic range for ≤11 months during ongoing SZC treatment.

The Author(s). Published by S. Karger AG, Basel.

Address: Renal Research, Gosford, New South Wales, Australia, [email protected].; Division of Nephrology, Department of Medicine, NewYork-Presbyterian Queens, New York, New York, USA.; Section of Nephrology, Advocate Christ Medical Center, University of Illinois at Chicago, Oak Lawn, Illinois, USA.; ZS Pharma, Inc., Part of AstraZeneca, San Mateo, California, USA.; School of Medicine, University of California, Irvine, California, USA.; Melbourne Renal Research Group and Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.; AstraZeneca, Gothenburg, Sweden.; Department of Cardiology, Saint Luke's Mid America Heart Institute and Department of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA.; The George Institute for Global Health and University of New South Wales, Sydney, New South Wales, Australia.
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