Lanthanum carbonate treatment, for up to 6 years, is not associated with adverse effects on the liver in patients with chronic kidney disease Stage 5 receiving hemodialysis.
OBJECTIVE
The efficacy and tolerability of the phosphate binder, lanthanum carbonate, have been evaluated in long-term comparative studies and subsequent open-label extensions. Animal studies show that lanthanum has a very low bioavailability and absorbed lanthanum is primarily excreted in bile. A specified subset of data from four Phase III clinical trials and subsequent extension studies is presented, in order to assess the effects of lanthanum carbonate on the liver.


METHODS
Hepatic biochemical tests for alanine transaminase, aspartate aminotransferase, alkaline phosphatase and bilirubin were performed. Adverse events classified as "liver and biliary system events" were recorded.


RESULTS
In the four initial clinical trials, lanthanum carbonate was not associated with any adverse changes in transaminases or bilirubin. The incidence and nature of adverse events associated with the liver during lanthanum carbonate treatment was similar to that in the comparator groups. For patients who enrolled into the subsequent long-term follow-up study (up to 6 years of treatment), changes in transaminases were not clinically relevant and mean values were similar to those observed in the earlier trials. Overall, there was no increase in the incidence of adverse events associated with the liver reported after up to 6 years of treatment when compared with the results of the initial studies.


CONCLUSIONS
There was no evidence of adverse effects of lanthanum carbonate on the liver in patients who received treatment for up to 6 years.
Hutchison
A J
AJ
Manchester Royal Infirmary, Manchester, UK. alastair.hutchison@cmmc.nhs.uk
Barnett
M E
ME
Krause
R
R
J
Siami
G A
GA
D000410:Alanine Transaminase / Q000032:analysis; D000469:Alkaline Phosphatase / Q000032:analysis; D001219:Aspartate Aminotransferases / Q000032:analysis; D018450:Disease Progression; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology / Q000628:therapy*; D007811:Lanthanum / Q000009:adverse effects / Q000627:therapeutic use*; D008099:Liver / Q000187:drug effects* / Q000201:enzymology; D008111:Liver Function Tests; D006435:Renal Dialysis; D005723:gamma-Glutamyltransferase / Q000032:analysis
C119467:lanthanum carbonate; D007811:Lanthanum; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase