- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Patiromer Promising in Optimizing HF Treatments for Patients with Hyperkalemia, DIAMOND Trial Reveals
USA: Recent findings highlight the role of patiromer in improving treatment outcomes for patients with heart failure and hyperkalemia.
The study, published in the Journal of the American College of Cardiology, revealed that in individuals with heart failure with reduced ejection fraction (HFrEF) and a history of hyperkalemia (HK), the addition of patiromer facilitates the optimization of renin-angiotensin system (RAS) inhibitors and mineralocorticoid antagonists (MRAs), which are essential components of heart failure management.
Hyperkalemia, characterized by elevated potassium levels in the blood, poses significant challenges in managing patients on RAS inhibitors and MRAs. These medications are crucial for treating heart failure, as they help improve heart function and reduce the risk of hospitalization and mortality. However, the occurrence of hyperkalemia often leads to the discontinuation or dose reduction of these therapies, undermining their benefits.
Against the above background, Bertram Pitt, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA, and colleagues aimed to evaluate the characteristics and usage of RAS inhibitors and MRAs in patients receiving patiromer during the run-in phase of the DIAMOND study (Patiromer for the Management of Hyperkalemia in Subjects Receiving RAASi Medications for the Treatment of Heart Failure).
Patients with HFrEF and hyperkalemia (HK) or a history of HK participated in a run-in phase of up to 12 weeks, during which patiromer facilitated the optimization of RAS inhibitors and MRAs to reach at least 50% of the recommended RAS inhibitor dose, 50 mg/day of MRA, and normokalemia. Those who met these criteria and entered the randomized group were compared with the run-in failure group, consisting of patients who did not meet the randomization criteria.
Based on the research, the following findings were revealed:
- Of 1,038 patients completing the run-in, 878 were randomized, and 160 were run-in failures.
- 40.7% of patients had HK entering run-in with a similar frequency in the randomized and run-in failure groups (40.3% versus 42.5%).
- From the start to the end of the run-in, in the randomized group, there was an increase in target RAS inhibitor and MRA use in patients with HK (RAS inhibitor: 76.8% to 98.6%; MRA: 35.9% to 98.6%) and past HK (RAS inhibitor: 60.5% to 98.1%; MRA: 15.6% to 98.7%).
- Despite not meeting the randomization criteria, there was an increase after run-in in the run-in failure group in target RAS inhibitor (52.5% to 70.6%) and MRA use (15.0% to 48.1%).
- This increase was observed in patients with HK (RAS inhibitor: 51.5% to 64.7%; MRA: 19.1% to 39.7%) and past HK (RAS inhibitor: 53.3% to 75.0%; MRA: 12.0% to 54.3%).
In their analysis during the run-in phase of the DIAMOND trial, the authors found that most patients with HFrEF and hyperkalemia or a history of HK could rapidly and safely optimize their RAS inhibitor and MRA therapy while achieving or maintaining normokalemia with the help of patiromer. Notably, neither hypotension nor worsening kidney function posed significant barriers to the optimization of these therapies in this high-risk population. Furthermore, among patients who were unable to be randomized in this uncontrolled segment of the study, the majority were still able to initiate, maintain, or uptitrate their RAS inhibitor and MRA doses alongside patiromer.
"These findings suggest that patiromer could play a vital role in enhancing and sustaining the use of RAS inhibitors and MRAs in patients with HFrEF and HK or a history of HK," the researchers concluded.
Reference:
Pitt, B., Anker, S. D., Lund, L. H., Coats, A. J., Filippatos, G., Rossignol, P., Weir, M. R., Friede, T., Kosiborod, M. N., Metra, M., Böhm, M., Ezekowitz, J. A., Bayes-Genis, A., Mentz, R. J., Ponikowski, P., Senni, M., Piña, I. L., Pinto, F. J., Van der Meer, P., . . . Butler, J. (2024). Patiromer Facilitates Angiotensin Inhibitor and Mineralocorticoid Antagonist Therapies in Patients With Heart Failure and Hyperkalemia. Journal of the American College of Cardiology, 84(14), 1295-1308. https://doi.org/10.1016/j.jacc.2024.05.079
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751