Heart Failure and Edema Risks with Sodium Zirconium Cyclosilicate vs. Patiromer
Author Information
Author(s): Nihar R. Desai, Jennifer Kammerer, Jeffrey Budden, Abisola Olopoenia, Asa Tysseling, Alexandra Gordon
Primary Institution: Yale School of Medicine
Hypothesis
Does sodium zirconium cyclosilicate (SZC) increase the risk of heart failure hospitalizations and edema compared to patiromer (PAT) in patients with hyperkalemia?
Conclusion
Sodium zirconium cyclosilicate use is associated with a higher risk of heart failure hospitalizations, severe edema, and death compared to patiromer.
Supporting Evidence
- Sodium zirconium cyclosilicate users had 37% higher risk of heart failure hospitalizations compared to patiromer users.
- Patients using sodium zirconium cyclosilicate experienced 29 more deaths per 1000 person-months than those using patiromer.
- Severe edema events were 33% more common in sodium zirconium cyclosilicate users compared to patiromer users.
Takeaway
This study found that using sodium zirconium cyclosilicate can lead to more hospital visits for heart problems and swelling compared to another medicine called patiromer.
Methodology
A retrospective cohort study using Cerner Real World Data to compare outcomes between new users of SZC and PAT.
Potential Biases
Residual confounding may exist despite propensity score matching.
Limitations
Potential selection bias as only individuals seeking care were included; outcomes may be misclassified; reliance on prescribed medication data.
Participant Demographics
Majority were older than 65 years, with about 50% having CKD stages 3-5 and 34% having a history of heart failure.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI for adjusted HRs ranged from 1.255 to 1.410 for various outcomes.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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