Lanthanum carbonate.
Lanthanum carbonate is a novel, non-aluminium, non-calcium phosphate binding agent that forms a water-insoluble compound, lanthanum phosphate, in the gut. Lanthanum carbonate (elemental lanthanum 375-3000 mg/day) reduced serum phosphorus levels compared with placebo in two randomised, double-blind, multicentre 4-week trials in patients with chronic renal failure receiving regular haemodialysis. In two large, randomised trials in patients with chronic renal failure requiring haemodialysis, lanthanum carbonate (elemental lanthanum 375-3000 mg/day) was as effective as calcium carbonate and/or other conventional phosphate binders in reducing and maintaining serum phosphorus levels (< or =5.6 mg/dL over 6 months and < or =5.9 mg/dL over 2 years). Lanthanum carbonate was generally well tolerated. Most adverse events were mild-to-moderate in severity, with gastrointestinal events being the most common. The tolerability profile of lanthanum carbonate was similar to those of conventional phosphate binders; however, hypercalcaemic episodes occurred significantly less frequently over 6 months with lanthanum carbonate than with calcium carbonate. In a randomised 1-year trial, numerically fewer lanthanum carbonate (elemental lanthanum < or =3750 mg/day) recipients had renal bone disease at study end than at baseline; however, in the calcium carbonate < or =9000 mg/day group, numerically more patients had renal bone disease at study end compared with baseline.
Swainston Harrison
Tracy
T
Adis International Limited, 41 Centorian Drive, Mairangi Bay, Auckland 1311, New Zealand. demail@adis.co.nz
Scott
Lesley J
LJ
D000818:Animals; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007811:Lanthanum / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D010710:Phosphates / Q000097:blood; D016032:Randomized Controlled Trials as Topic; D006435:Renal Dialysis
D010710:Phosphates; C119467:lanthanum carbonate; D007811:Lanthanum