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

Am J Nephrol. 2019;50(6):473-480. doi: 10.1159/000504078. Epub 2019 Oct 28.

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.

Keywords: Extension; HARMONIZE; Hyperkalemia; Sodium zirconium cyclosilicate.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Hyperkalemia / blood
  • Hyperkalemia / drug therapy*
  • Ion Exchange Resins / administration & dosage*
  • Ion Exchange Resins / adverse effects
  • Male
  • Middle Aged
  • Potassium / blood*
  • Potassium / metabolism
  • Prospective Studies
  • Renin-Angiotensin System
  • Silicates / administration & dosage*
  • Silicates / adverse effects
  • Treatment Outcome

Substances

  • Ion Exchange Resins
  • Silicates
  • sodium zirconium cyclosilicate
  • Potassium