Locatelli Francesco, Spasovski Goce, Dimkovic Nada, Wanner Christoph
Department of Nephrology, Alessandro Manzoni Hospital, Lecco, Italy.
Blood Purif. 2016;41(4):247-53. doi: 10.1159/000441648. Epub 2015 Dec 16.
This study investigated in a North American patient population the longer-term treatment effects of the phosphate binder, colestilan, in patients with CKD Stage 5D and hyperphosphataemia.
One hundred and sixteen CKD Stage 5D patients with hyperphosphataemia were entered into a multi-centre, open-label study where they received flexible dose colestilan (6-15 g/day) to maintain serum phosphorus levels between 3.5 and 5.5 mg/dl. The primary endpoint was safety, assessed by treatment-emergent adverse events. Efficacy was assessed by changes in serum phosphorus, mineral metabolism, lipids, HbA1c, uric acid and bone markers.
Serum phosphorus was significantly reduced by 1.18 mg/dl (p < 0.001), from 6.99 mg/dl at baseline to 5.80 mg/dl at week 52. LDL-cholesterol was also significantly reduced as well as uric acid. Significant change was observed only for one bone marker - PINP. Most adverse events were of mild or moderate intensity. Nausea (22.4%), vomiting (21.6%), and diarrhoea (19.8%) were most commonly reported.
Long-term flexible dosing with colestilan reduces serum phosphorus and demonstrates an acceptable safety and tolerability profile.
本研究在北美患者群体中调查了磷结合剂考来替兰对5D期慢性肾脏病(CKD)和高磷血症患者的长期治疗效果。
116例5D期CKD高磷血症患者进入一项多中心、开放标签研究,接受灵活剂量的考来替兰(6 - 15克/天)以维持血清磷水平在3.5至5.5毫克/分升之间。主要终点是安全性,通过治疗中出现的不良事件进行评估。疗效通过血清磷、矿物质代谢、血脂、糖化血红蛋白、尿酸和骨标志物的变化进行评估。
血清磷从基线时的6.99毫克/分升显著降低1.18毫克/分升(p < 0.001),至第52周时为5.80毫克/分升。低密度脂蛋白胆固醇以及尿酸也显著降低。仅观察到一种骨标志物——I型前胶原氨基端前肽(PINP)有显著变化。大多数不良事件为轻度或中度。最常报告的是恶心(22.4%)、呕吐(21.6%)和腹泻(19.8%)。
考来替兰长期灵活给药可降低血清磷,并显示出可接受的安全性和耐受性。