Patiromer Utility as an Adjunct Treatment in Patients Needing Urgent Hyperkalemia Management
- Conditions
- Hyperkalemia
- Interventions
- Registration Number
- NCT04443608
- Lead Sponsor
- Comprehensive Research Associates
- Brief Summary
When a patient arrives to an emergency department and is found to have an elevated potassium level in the blood, there is no one standardized treatment, therefore it is not known if one treatment is superior to other. The purpose of this study is to help determine if a drug called patiromer (already approved by the FDA) can help lower potassium levels while patients are in the emergency department.
- Detailed Description
Given the lack of consistency in hyperkalemia treatment in the ED and the high cost of emergent dialysis, there is a need for the development and systematic evaluation of a treatment protocol to shift potassium into the cells followed by the removal of potassium from the body with a potassium binder.. The present study will use a systematic approach to shifting potassium into the cells followed by binding potassium in the gastrointestinal tract in hyperkalemic patients presenting to the ED. Study subjects will receive patiromer or placebo to determine if patiromer reduces the need for additional medical intervention for the management of hyperkalemia in patients initially treated with IV and inhaled therapy in the ED.
Upon enrollment, patiromer will be administered at a dose selected because of its safety and efficacy shown in a pilot study named REDUCE.
Up to 300 patients will be enrolled and followed for up to 14 days, and potassium levels will be measured at pre-determined intervals to assess drug's impact. concomitant medications will be recorded to help determine if study drug helped, not just lower hyperkalemia, but also decrease the number of total interventions needed to reach a normal potassium level.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 115
- Hyperkalemia, defined as K+ ≥5.8 obtained via local laboratory or point-of-care testing
- Written informed consent obtained.
- Clinically significant arrhythmia, defined as any arrhythmia requiring ongoing IV antiarrhythmic therapy.
- Patients who are hemodynamically unstable, defined as mean arterial pressure ≤65 mmHg or heart rate ≤40 beats per minute or ≥125 beats per minute at time of screening
- Hyperkalemia solely due to overdose on potassium supplements
- Known bowel obstruction
- Subjects currently being treated with or having taken potassium binders (e.g., patiromer, sodium or calcium polystyrene sulfonate or sodium zirconium cyclosilicate) in the 7 days prior to baseline
- Subjects expected to receive dialysis during the first 6 hours of the study treatment period
- Known hypersensitivity to patiromer or its ingredients
- Participation in any other investigational device or drug study <30 days prior to screening, or current treatment with other investigational agent(s)
- Inability to consume the investigational product or, in the opinion of the Investigator unsuitable for study participation
- Life expectancy of less than 6 months
- Patients with automatically timed medication orders to control potassium in the ED
- Patient is known to be pregnant or breastfeeding
- An employee of investigational site or sponsors
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Veltassa Patiromer Powder for Oral Suspension [Veltassa] 3 packets of study drug powder will be mixed with a liquid (water, apple or cranberry juice) and given to patient to drink while in the emergency department Placebo Placebo 3 packets of study drug powder will be mixed with a liquid (water, apple or cranberry juice) and given to patient to drink while in the emergency department
- Primary Outcome Measures
Name Time Method The need for additional potassium-lowering medical interventions Duration of patient's emergency department visit, up to 6 hours Net clinical benefit (mean difference in number of interventions less change in serum potassium)
- Secondary Outcome Measures
Name Time Method Potassium level trends after receiving study drug Up to 24 hours after study drug dose is given K+ 24 hours after ED discharge
Trial Locations
- Locations (19)
University of Mississippi Medical Center
🇺🇸Jackson, Mississippi, United States
Stony Brook University Hospital
🇺🇸Stony Brook, New York, United States
Ohio State University. Wexner Medical Center
🇺🇸Columbus, Ohio, United States
Hennepin Healthcare Research Institute
🇺🇸Minneapolis, Minnesota, United States
University of Cincinnati
🇺🇸Cincinnati, Ohio, United States
Baylor College of Medicine
🇺🇸Houston, Texas, United States
UT Memorial Hermann Hospital
🇺🇸Houston, Texas, United States
Stanford University School of Medicine
🇺🇸Stanford, California, United States
Yale University
🇺🇸New Haven, Connecticut, United States
George Washington University
🇺🇸Washington, District of Columbia, United States
Christiana Care
🇺🇸Newark, Delaware, United States
Wayne State University
🇺🇸Detroit, Michigan, United States
Henry Ford Hospital
🇺🇸Detroit, Michigan, United States
Washington University of St Louis
🇺🇸Saint Louis, Missouri, United States
Mt Sinai. Icahn School of Medicine
🇺🇸New York, New York, United States
Maimonides Medical Center
🇺🇸New York, New York, United States
Wake Forest University Health Sciences
🇺🇸Winston-Salem, North Carolina, United States
JPS Health Network
🇺🇸Fort Worth, Texas, United States
Baystate Medical Center
🇺🇸Springfield, Massachusetts, United States