In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Patiromer reduced serum K+ in hyperkalaemic patients with HF and advanced CKD on RAAS inhibitors: Results from OPAL-HK and AMETHYST-DN

Session Poster session 2

Speaker Bertram Pitt

Congress : ESC Congress 2015

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure - Other
  • Session type : Poster Session
  • FP Number : P1799

Authors : B Pitt (Ann Arbor,US), M Weir (Baltimore,US), DA Bushinsky (Rochester,US), M Mayo (Redwood City,US), D Garza (Redwood City,US), Y Stasiv (Redwood City,US), C Du Mond (Redwood City,US), L Berman (Redwood City,US), G Bakris (Chicago,US)

B. Pitt1 , M. Weir2 , D.A. Bushinsky3 , M. Mayo4 , D. Garza4 , Y. Stasiv4 , C. Du Mond4 , L. Berman4 , G. Bakris5 , 1University of Michigan - Ann Arbor - United States of America , 2University of Maryland - Baltimore - United States of America , 3University of Rochester - Rochester - United States of America , 4Relypsa, Inc. - Redwood City - United States of America , 5University of Chicago Medicine - Chicago - United States of America ,

European Heart Journal ( 2015 ) 36 ( Abstract Supplement ), 318-319

Introduction: RAAS inhibitors (RAASi) reduce mortality in patients (pts) with HF ± CKD, yet hyperkalaemia (HK) can limit RAASi use in these pts. We evaluated the effect of patiromer, a novel investigational K+ binder, on serum K+ (s-K+) in HK pts with HF and advanced CKD on RAASi.

Methods: OPAL-HK (OP) was a 12-wk, 2-part, randomised, single-blind study; AMETHYST-DN (A-DN) was a 52-wk, randomised, open-label study. Eligible pts had eGFR 15–59, were on ≥1RASSi and, in A-DN, had T2DM; pts with NYHA class 4–5 HF were excluded. Entry s-K+ was 5.1-<6.5 mEq/L (OP) and >5.0-<6.0 mEq/L (A-DN). In a posthoc subgroup analysis, efficacy data were pooled over the 1st 4 wk in pts with HF and stage 3b-5 CKD and analysed for s-K+ change from baseline (1° endpoint) by s-K+ strata: >5.0–5.5 (mild) and >5.5-<6.0 mEq/L (mod/severe) in A-DN; 5.1-<5.5 (mild) and 5.5-<6.5 mEq/L (mod/severe) in OP.

Results: Of HF pts with advanced CKD, 66 had mild and 66 had mod/severe HK. Pts were primarily male (∼60%) and ≥65 yr (62%); mean±SD eGFR was 29±10 in mild and 27±9 mL/min/1.73m2 in mod/severe pts. With patiromer mean s-K+ was reduced to <5.0 mEq/L by the first post-baseline visit (Day 3) in mild HK and by wk 1 in mod/severe HK pts and continued to improve (Fig). By wk 4, mean (95% CI) s-K+ change from baseline was −0.62 mEq/L (−0.74, −0.50) in mild HK and −1.13 mEq/L (−1.28, −0.97) in mod/severe HK pts; both P<0.001. One pt developed s-K+ <3.5 mEq/L through wk 4. AEs were predominately mild-to-moderate GI complaints; AEs led to patiromer discontinuation in 6 pts in each study over the entire study period.

Conclusions: Patiromer significantly reduced s-K+ in HK patients with HF and advanced CKD over 4 wk. If approved, patiromer may be an option for HK treatment in pts with HF and advanced CKD.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from ESC Congress and ESC Asia with APSC & AFC
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s congress resources
  • 3Under 40 or in training - with a Combined Membership, access resources from all congresses
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are