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VELTASSA significantly lowered serum K+1

OPAL CHART XL
  • Mean baseline of 5.74 mEq/L in moderate to severe hyperkalemia population with mean change of –1.23 mEq/L at week 4 (P<0.001)
  • All patients were receiving a stable dose of RAAS inhibitors at baseline

In an exploratory analysis of the OPAL-HK 12-week study:

  • 94% of VELTASSA patients remained on RAAS-inhibitor therapy at week 12, vs 44% of placebo patients

Normokalemia was defined as serum K+ within the target range of 3.8 to < 5.1 mEq/L.
The mean change in patients with mild hyperkalemia from baseline (5.31 mEq/L) was –0.65 mEq/L (P<0.001).

*Baseline serum K+=5.1 to < 5.5 mEq/L.

Baseline serum K+=5.5 to < 6.5 mEq/L.

Study design

A phase 3, 2-part, 12-week, multicenter study consisting of a 4-week, single-group, single-blind initial treatment phase and an 8-week, placebo-controlled, single-blind, randomized withdrawal phase in adult patients with CKD stage 3 or 4. Patients had serum K+ of 5.1 to < 6.5 mEq/L and were receiving a stable dose of RAAS inhibitors.

Exploratory analysis in the OPAL-HK 12-week study

Treatment of hyperkalemia in patients with CKD taking RAAS inhibitors
The Statistical Analysis Plan (SAP) defined exploratory efficacy outcomes that measured the proportion of patients receiving any dose of RAAS inhibitors at week 8 in Part B of the study.

VELTASSA was studied in patients like yours who are vulnerable to hyperkalemia1-5

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VELTASSA worked within hours for low-K+ diet–resistant HK patients

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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.

ACE=angiotensin-converting enzyme; ARB=angiotensin II receptor blocker; CKD=chronic kidney disease; CV=cardiovascular; RAAS=renin-angiotensin-aldosterone system.

  1. References:
  2. Weir MR, Bakris GL, Bushinsky DA, et al; for OPAL-HK Investigators. Patiromer in patients with kidney disease and hyperkalemia receiving RAAS inhibitors. N Engl J Med. 2015;372(3):211–221. doi:10.1056/NEJMoa1410853 
  3. Bakris GL, Pitt B, Weir MR, et al; for AMETHYST-DN Investigators. Effect of patiromer on serum potassium level in patients with hyperkalemia and diabetic kidney disease: the AMETHYST-DN randomized clinical trial. JAMA. 2015;314(2):151–161. doi:10.1001/jama.2015.7446 
  4. Pinnell D, Patel S, Qualls J, et al. Real-world evaluation of patiromer utilization and its effects on serum potassium in veterans with end stage kidney disease. Medicine (Baltimore). 2022;101(50):e32367. doi:10.1097/MD.0000000000032367 
  5. Kovesdy CP, Rowan CG, Conrad A, et al. Real-world evaluation of patiromer for the treatment of hyperkalemia in hemodialysis patients. Kidney Int. 2018;4(2):301–309. doi:10.1016/j.ekir.2018.10.020 
  6. Amdur RL, Paul R, Barrows ED, et al. The potassium regulator patiromer affects serum and stool electrolytes in patients receiving hemodialysis. Kidney Int. 2020;98(5):1331–1340. doi:10.1016/j.kint.2020.06.042