title: Novel iron-containing phosphate binders for treatment of hyperphosphatemia.
abstract: BACKGROUND
  Hyperphosphatemia is a frequent complication of chronic kidney disease and is associated with increased mortality. Despite side effects, risk of accumulation and high costs, phosphate binders (PBs) have become the crucial cornerstone of therapy. The iron-containing PB sucroferric oxyhydroxide (SO) and ferric citrate hydrate (FCH) have entered the market and other candidates are prior market entry.
  
  
  METHODS
  A literature search was performed using MEDLINE and EMBASE databases to identify references on iron-containing PB with particular regard to efficacy, safety and potential benefits. Additional hand searches were conducted along with a full-text review of any citation that appeared relevant.
  
  
  CONCLUSIONS
  On the highly competitive market, where the 'ideal' PB is still unknown, novel substances that offer clear benefits over available drugs are desired. Although SO and FCH showed similar efficacy and safety compared to sevelamer, head-to-head studies with lanthanum carbonate are absent. Clinical 1-year data in a limited patient cohort suggested improved adherence for SO and a large randomized controlled trial showed significant reduction in hospitalizations and costs for FCH. Additional large randomized controlled trials have now to prove these possible advantages. Cost-effectiveness in comparison to other PB and the exclusion of significant harms under long-term treatment will determine the future use of both drugs.
authors: a 1 KFH Nierenzentrum Muenchen Laim , Elsenheimerstr. 63, D-80687 Munich, Germany +49 8 95 47 26 70 ; +49 8 95 70 57 27 ; holger.schmid@lrz.uni-muenchen.de.
authors: Holger
authors: H
authors: Schmid
authors: b 2 Munich University Hospital, Clinic and Policlinic IV, Section of Nephrology , Munich, Germany.
authors: Stephan R
authors: SR
authors: Lederer
mesh_terms: D000818:Animals; D002254:Carbonates / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004338:Drug Combinations; D005290:Ferric Compounds / Q000627:therapeutic use*; D006801:Humans; D054559:Hyperphosphatemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D007501:Iron / Q000627:therapeutic use; D007811:Lanthanum / Q000627:therapeutic use; D008274:Magnesium / Q000627:therapeutic use; D010710:Phosphates / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D000069603:Sevelamer / Q000627:therapeutic use; D013213:Starch / Q000627:therapeutic use; D013395:Sucrose / Q000627:therapeutic use
chemical_list: D002254:Carbonates; D004338:Drug Combinations; D005290:Ferric Compounds; D010710:Phosphates; C570356:SBR 759; C000599459:sucroferric oxyhydroxide; C119467:lanthanum carbonate; D013395:Sucrose; C025314:ferric citrate; D007811:Lanthanum; D013213:Starch; D000069603:Sevelamer; D007501:Iron; D008274:Magnesium; C541219:iron-magnesium hydroxycarbonate
keywords: PT20; adherence; chronic kidney disease; costs; dialysis; erythropoiesis-stimulating agent; fermagate; ferric citrate hydrate; hyperphosphatemia; iron; phosphate binder; sucroferric oxyhydroxide