Efficacy of calcium-free phosphate binders in patients receiving regular hemodialysis

Kotenko O.N., Skiperskikh P.V., Belenikina Ya.A., Yuzefovich V.A., Smirnova E.A.

1) Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department, Moscow, Russia; 2) Ryazan State Medical University named after Academician I.P. Pavlov, Ryazan, Russia; 3) City Clinical Hospital No. 11, Ryazan, Russia; 4) Pirogov Russian National Research Medical University, Moscow, Russia

Background. Hyperphosphatemia is an independent predictor of cardiovascular complications and mortality in patients on hemodialysis (HD). Phosphorus control remains an unresolved issue, despite dietary interventions and phosphate-binding therapy. Non-calcium phosphate binders (sevelamer carbonate, sucroferric oxyhydroxide) are recommended as the drugs of choice, but their direct comparison in real-world clinical practice has not been adequately studied.
Objective. Evaluation of the efficacy and safety of the phosphate binders sevelamer and β sucroferric oxyhydroxide in patients with hyperphosphatemia receiving HD.
Materials and methods. An open-label, multicenter, observational, non-interventional study was conducted to evaluate the results of hyperphosphatemia correction with the aforementioned phosphate binders over 24 weeks. The study included 90 patients receiving programm HD at dialysis centers in Moscow and Ryazan who met the inclusion criteria. The study patients were randomized in a 1:1 ratio: 45 patients received sevelamer carbonate (Selamerex®, ZAO Sotex PharmFirm), and the other 45 patients received sucroferric oxyhydroxide (Velphoro®, Vifor S.A. Switzerland).
Results. Over the follow-up period, the mean phosphorus level decreased statistically significantly in both groups. Calcium, parathyroid hormone, and alkaline phosphatase levels remained unchanged. The incidence of self-reported gastrointestinal side effects was higher in the Velphoro® group.
Conclusion. Results of a 24-week study using the phosphate binders sevelamer and sucroferric oxyhydroxide in patients on program HD demonstrated comparable efficacy in controlling hyperphosphatemia, improving biochemical markers of bone mineral metabolism disorders, and the safety of regular use.

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About the Authors

Oleg N. Kotenko – Dr.Sci. (Med.), Chief External Expert in Nephrology of the Moscow Healthcare Department, Chief External Expert in Nephrology for the Central Federal District of the Ministry of Health of the Russian Federation, President of the Metropolitan Association of Nephrologists of Russia. Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow; e-mail: olkotenko@yandex.ru. ORCID: 0000-0001-8264-7374
Polina V. Skiperskikh – Teaching Assistant at the Department of Internal Medicine, Ryazan State Medical University named after Academician I.P. Pavlov. Address: 9 Vysokovoltnaya St., Ryazan, 390026; General Practitioner, City Clinical Hospital No. 11. Address: 26/17 Vysokovoltnaya St., Ryazan, 390037; e-mail: polinaskip@gmail.com. ORCID: 0009-0002-5267-7147, eLibrary SPIN: 3422-3985
Yana A. Belenikina – Cand.Sci. (Med.), Associate Professor, Department of Internal Medicine, Ryazan State Medical University named after Academician I.P. Pavlov. Address: 9 Vysokovoltnaya St., Ryazan, 390026; e-mail: jnb22@rambler.ru. ORCID: 0000-0002-7325-5448, eLibrary SPIN: 2937-5048
Valeria A. Yuzefovich – Head of the Hemodialysis Department, Nephrologist, City Clinical Hospital No. 11. Address: 26/17 Novoselov St., Ryazan, 390037; e-mail: askolkovav@mail.ru. ORCID: 0009-0008-6643-0384
Elena A. Smirnova – Dr.Sci. (Med.), Associate Professor, Head of the Department of Internal Medicine, Ryazan State Medical University named after Academician I.P. Pavlov. Address: 9 Vysokovoltnaya St., Ryazan, 390026; e-mail: smirnova-ea@inbox.ru. ORCID: 0000-0003-0334-6237, eLibrary SPIN: 6503-8046

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