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Hyperkalaemia and potassium binders: Retrospective observational analysis looking at the efficacy and cost effectiveness of calcium polystyrene sulfonate and sodium zirconium cyclosilicate

Huda, Abdullah Bin, Langford, Charlotte, Lake, James, Langford, Nigel (2022) Hyperkalaemia and potassium binders: Retrospective observational analysis looking at the efficacy and cost effectiveness of calcium polystyrene sulfonate and sodium zirconium cyclosilicate. Journal of Clinical Pharmacy and Therapeutics, 47 (12). pp. 2170-2175. ISSN 0269-4727. E-ISSN 1365-2710. (doi:10.1111/jcpt.13766) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:99367)

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Official URL:
https://doi.org/10.1111/jcpt.13766

Abstract

What is Known and Objective

Hyperkalaemia is a common medical emergency in patients admitted to hospital. There is a limited evidence base supporting some of the commonly applied treatment strategies. Although, NICE has recommended the use of sodium zirconium cyclosilicate (SZC) (TA599) and patiromer (TA623) in both acute and chronic hyperkalaemia, there is a limited evidence base for their use in acute hyperkalaemia in the hospital setting, particularly when compared to the present standard of care calcium polystyrene sulfonate (CPS).

Methods

A retrospective review of the electronic patient record system across our hospital over a 6-month period identified 138 patients who received either SZC (65 patients) or CPS (73 patients) to manage hyperkalaemia, investigating their efficacy and cost effectiveness. Results were analysed using simple descriptive statistics. Based on the results a naïve cost comparison between the two drugs was made.

Results and Discussion

CPS and SZC both effectively reduced plasm potassium concentrations in patients with hyperkalaemia (6.07 and 6.03 mmol/L respectively) by 1.17 mmol/L and 1.24 mmol/L taking a similar amount of time to work (2.97 days vs. 3 days). The principle causes of hyperkalaemia identified were acute kidney injury, medication, and chronic kidney disease. Cost comparison analysis which took into account raw product price and time needed to dispense medications revealed that CPS has slightly better cost effectiveness compared to SZC albeit at a cost of increased staff input.

What is New and Conclusion

Both CPS and SZC were equally effective at lowering acutely raised potassium concentrations. The cost difference between the two products appears to be small. Claims regarding the benefits of newer agents over older established medications need to be properly explored in randomized trials rather than being based on small scale non-comparative studies.

Item Type: Article
DOI/Identification number: 10.1111/jcpt.13766
Uncontrolled keywords: Pharmacology (medical), Pharmacology
Subjects: Q Science > QH Natural history > QH301 Biology
Divisions: Divisions > Division of Natural Sciences > Biosciences
Funders: University Hospitals of Leicester NHS Trust (https://ror.org/02fha3693)
SWORD Depositor: JISC Publications Router
Depositing User: JISC Publications Router
Date Deposited: 13 Jan 2023 16:36 UTC
Last Modified: 23 Aug 2024 14:12 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/99367 (The current URI for this page, for reference purposes)

University of Kent Author Information

Langford, Charlotte.

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