Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2022 |
| Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | http://hdl.handle.net/10451/61692 |
Resumo: | © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. F |
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Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trialHeart failure with reduced ejection fractionHyperkalemiaPatiromerPotassium-binding polymerRenin–angiotensin–aldosterone system inhibitor (RAASi)© The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. FAims: To investigate the impact of patiromer on the serum potassium level and its ability to enable specified target doses of renin-angiotensin-aldosterone system inhibitor (RAASi) use in patients with heart failure and reduced ejection fraction (HFrEF). Methods and results: A total of 1642 patients with HFrEF and current or a history of RAASi-related hyperkalemia were screened and 1195 were enrolled in the run-in phase with patiromer and optimization of the RAASi therapy [≥50% recommended dose of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin inhibitor, and 50 mg of mineralocorticoid receptor antagonist (MRA) spironolactone or eplerenone]. Specified target doses of the RAASi therapy were achieved in 878 (84.6%) patients; 439 were randomized to patiromer and 439 to placebo. All patients, physicians, and outcome assessors were blinded to treatment assignment. The primary endpoint was between-group difference in the adjusted mean change in serum potassium. Five hierarchical secondary endpoints were assessed. At the end of treatment, the median (interquartile range) duration of follow-up was 27 (13-43) weeks, the adjusted mean change in potassium was +0.03 mmol/l in the patiromer group and +0.13 mmol/l in the placebo group [difference in the adjusted mean change between patiromer and placebo: -0.10 mmol/l (95% confidence interval, CI -0.13, 0.07); P < 0.001]. Risk of hyperkalemia >5.5 mmol/l [hazard ratio (HR) 0.63; 95% CI 0.45, 0.87; P = 0.006), reduction of MRA dose (HR 0.62; 95% CI 0.45, 0.87; P = 0.006), and total adjusted hyperkalemia events/100 person-years (77.7 vs. 118.2; HR 0.66; 95% CI 0.53, 0.81; P < 0.001) were lower with patiromer. Hyperkalemia-related morbidity-adjusted events (win ratio 1.53, P < 0.001) and total RAASi use score (win ratio 1.25, P = 0.048) favored the patiromer arm. Adverse events were similar between groups. Conclusion: Concurrent use of patiromer and high-dose MRAs reduces the risk of recurrent hyperkalemia (ClinicalTrials.gov: NCT03888066).This work was supported by Vifor Pharma. Funding to pay the Open Access publication charge for this article was provided by Vifor Pharma.Oxford University PressRepositório da Universidade de LisboaButler, JavedAnker, Stefan D.Lund, Lars HCoats, Andrew J. S.Filippatos, GerasimosSiddiqi, Tariq JamalFriede, TimFabien, VincentKosiborod, MikhailMetra, MarcoPiña, Ileana L.Pinto, Fausto J.Rossignol, Patrickvan der Meer, PeterBahit, CeciliaBelohlavek, JanBöhm, MichaelBrugts, Jasper J.Cleland, John G. F.Ezekowitz, JustinBayes-Genis, AntoniGotsman, IsraelGoudev, AssenKhintibidze, IrakliLindenfeld, JoannMentz, Robert J.Merkely, BelaMontes, Eliodoro CastroMullens, WilfriedNicolau, Jose C.Parkhomenko, AleksandrPonikowski, PiotrSeferovic, Petar M.Senni, MicheleShlyakhto, EvgenyCohen-Solal, AlainSzecsödy, PeterJensen, KlausDorigotti, FabioWeir, Matthew R.Pitt, Bertram2024-01-10T12:23:23Z20222022-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/61692engEur Heart J. 2022 Nov 1;43(41):4362-43730195-668X10.1093/eurheartj/ehac4011522-9645info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-01-15T01:18:45Zoai:repositorio.ul.pt:10451/61692Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T01:44:34.863253Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
| dc.title.none.fl_str_mv |
Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial |
| title |
Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial |
| spellingShingle |
Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial Butler, Javed Heart failure with reduced ejection fraction Hyperkalemia Patiromer Potassium-binding polymer Renin–angiotensin–aldosterone system inhibitor (RAASi) |
| title_short |
Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial |
| title_full |
Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial |
| title_fullStr |
Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial |
| title_full_unstemmed |
Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial |
| title_sort |
Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial |
| author |
Butler, Javed |
| author_facet |
Butler, Javed Anker, Stefan D. Lund, Lars H Coats, Andrew J. S. Filippatos, Gerasimos Siddiqi, Tariq Jamal Friede, Tim Fabien, Vincent Kosiborod, Mikhail Metra, Marco Piña, Ileana L. Pinto, Fausto J. Rossignol, Patrick van der Meer, Peter Bahit, Cecilia Belohlavek, Jan Böhm, Michael Brugts, Jasper J. Cleland, John G. F. Ezekowitz, Justin Bayes-Genis, Antoni Gotsman, Israel Goudev, Assen Khintibidze, Irakli Lindenfeld, Joann Mentz, Robert J. Merkely, Bela Montes, Eliodoro Castro Mullens, Wilfried Nicolau, Jose C. Parkhomenko, Aleksandr Ponikowski, Piotr Seferovic, Petar M. Senni, Michele Shlyakhto, Evgeny Cohen-Solal, Alain Szecsödy, Peter Jensen, Klaus Dorigotti, Fabio Weir, Matthew R. Pitt, Bertram |
| author_role |
author |
| author2 |
Anker, Stefan D. Lund, Lars H Coats, Andrew J. S. Filippatos, Gerasimos Siddiqi, Tariq Jamal Friede, Tim Fabien, Vincent Kosiborod, Mikhail Metra, Marco Piña, Ileana L. Pinto, Fausto J. Rossignol, Patrick van der Meer, Peter Bahit, Cecilia Belohlavek, Jan Böhm, Michael Brugts, Jasper J. Cleland, John G. F. Ezekowitz, Justin Bayes-Genis, Antoni Gotsman, Israel Goudev, Assen Khintibidze, Irakli Lindenfeld, Joann Mentz, Robert J. Merkely, Bela Montes, Eliodoro Castro Mullens, Wilfried Nicolau, Jose C. Parkhomenko, Aleksandr Ponikowski, Piotr Seferovic, Petar M. Senni, Michele Shlyakhto, Evgeny Cohen-Solal, Alain Szecsödy, Peter Jensen, Klaus Dorigotti, Fabio Weir, Matthew R. Pitt, Bertram |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Repositório da Universidade de Lisboa |
| dc.contributor.author.fl_str_mv |
Butler, Javed Anker, Stefan D. Lund, Lars H Coats, Andrew J. S. Filippatos, Gerasimos Siddiqi, Tariq Jamal Friede, Tim Fabien, Vincent Kosiborod, Mikhail Metra, Marco Piña, Ileana L. Pinto, Fausto J. Rossignol, Patrick van der Meer, Peter Bahit, Cecilia Belohlavek, Jan Böhm, Michael Brugts, Jasper J. Cleland, John G. F. Ezekowitz, Justin Bayes-Genis, Antoni Gotsman, Israel Goudev, Assen Khintibidze, Irakli Lindenfeld, Joann Mentz, Robert J. Merkely, Bela Montes, Eliodoro Castro Mullens, Wilfried Nicolau, Jose C. Parkhomenko, Aleksandr Ponikowski, Piotr Seferovic, Petar M. Senni, Michele Shlyakhto, Evgeny Cohen-Solal, Alain Szecsödy, Peter Jensen, Klaus Dorigotti, Fabio Weir, Matthew R. Pitt, Bertram |
| dc.subject.por.fl_str_mv |
Heart failure with reduced ejection fraction Hyperkalemia Patiromer Potassium-binding polymer Renin–angiotensin–aldosterone system inhibitor (RAASi) |
| topic |
Heart failure with reduced ejection fraction Hyperkalemia Patiromer Potassium-binding polymer Renin–angiotensin–aldosterone system inhibitor (RAASi) |
| description |
© The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. F |
| publishDate |
2022 |
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2022 2022-01-01T00:00:00Z 2024-01-10T12:23:23Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/10451/61692 |
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http://hdl.handle.net/10451/61692 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
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Eur Heart J. 2022 Nov 1;43(41):4362-4373 0195-668X 10.1093/eurheartj/ehac401 1522-9645 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Oxford University Press |
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Oxford University Press |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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