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Reduced serum K+ in pediatric patients

VELTASSA is the only K+ binder with a formal pediatric indication (12 to 17 years of age)1,2
In the EMERALD-1 study, after the 2-week dose-finding phase:

Summary of results in reduced serum k+ in pediatric patients
  • Mean (SD) baseline serum K+ was 5.5 mEq/L (0.3 mEq/L)
  • VELTASSA dose was titrated, as needed, based on serum K+ levels and was assessed on days 3, 7, and 14 with the aim of maintaining serum K+ in the target range*
  • All 14 patients 12 to 17 years of age completed the dose-finding phase
  • Median dose at day 14 was 4.2 g/day

*Normokalemia was defined as serum K+ within the target range of 3.8 to < 5.0 mEq/L.

 

Study design

An open-label, single-arm study in pediatric patients 12 to 17 years of age with CKD and hyperkalemia evaluated the potassium-lowering effect of VELTASSA. The study included an initial 14-day dose-finding phase, followed by an up to 24-week long-term treatment phase and a 2-week follow-up period. VELTASSA was given once daily as a powder for oral suspension.

Initial dose was at 4.2 g/day and titrated as needed to 8.4 g/day.

The mean age was 14.5 years, 79% were male, and all were white. The average weight at baseline was 51 kg and 57% of patients had a baseline eGFR < 30 mL/min/1.73 m2. Approximately 57% were on RAAS inhibitor therapy at baseline.

VELTASSA acts where K+ is most abundant

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INDICATION

VELTASSA is indicated for the treatment of hyperkalemia in adults and pediatric patients ages 12 years and older.

Limitation of Use: VELTASSA should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.

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INDICATION & Important Safety Information

Important Safety Information

VELTASSA is indicated for the treatment of hyperkalemia.

Limitation of Use: VELTASSA should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.

CONTRAINDICATIONS

VELTASSA is contraindicated in patients with a history of a hypersensitivity reaction to VELTASSA or any of its components.

INDICATION

VELTASSA is indicated for the treatment of hyperkalemia in adults and pediatric patients ages 12 years and older.

Limitation of Use: VELTASSA should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

VELTASSA is contraindicated in patients with a history of a hypersensitivity reaction to VELTASSA or any of its components.

WARNINGS AND PRECAUTIONS

Worsening of Gastrointestinal Motility: Avoid use of VELTASSA in patients with severe constipation, bowel obstruction or impaction, including abnormal post-operative bowel motility disorders, because VELTASSA may be ineffective and may worsen gastrointestinal conditions. Patients with a history of bowel obstruction or major gastrointestinal surgery, severe gastrointestinal disorders, or swallowing disorders were not included in clinical studies.

Hypomagnesemia: VELTASSA binds to magnesium in the colon, which can lead to hypomagnesemia. In clinical studies, hypomagnesemia was reported as an adverse reaction in 5.3% of adult patients treated with VELTASSA. Approximately 9% of adult patients in clinical trials developed hypomagnesemia with a serum magnesium value < 1.4 mg/dL. Monitor serum magnesium. Consider magnesium supplementation in patients who develop low serum magnesium levels.

MOST COMMON ADVERSE REACTIONS

The most common adverse reactions (incidence ≥  2%) in adult patients treated with VELTASSA were constipation (7.2%), hypomagnesemia (5.3%), diarrhea (4.8%), nausea (2.3%), abdominal discomfort (2.0%) and flatulence (2.0%). Mild to moderate hypersensitivity reactions were reported in 0.3% of adult patients treated with VELTASSA and included edema of the lips.The safety profile of VELTASSA in a study of 14 pediatric patients ages 12 to 17 years was generally similar to that observed in adult patients.

CKD=chronic kidney disease; eGFR=estimated glomerular filtration rate; EHR=electronic health record; 
RAAS=renin-angiotensin-aldosterone system; SD=standard deviation.

References:  1. Kayexalate®. Product information. Sanofi Aventis US LLC; 2017.  2. Lokelma®. Package insert. AstraZeneca Pharmaceuticals LP; 2024. 3. Data on file (6/22), CSL Vifor, Inc.