Lower Rates Of Hyperkalemia-related Hospitalization With Long-term Outpatient Sodium Zirconium Cyclosilicate Therapy In Patients With Kidney Disease Or Heart Failure

Introduction

While prior studies indicate that patients with long-term sodium zirconium cyclosilicate (SZC) treatment experience lower rates of hyperkalemia (HK)-related hospitalizations compared to patients with short-term SZC treatment, this has not been evaluated among patients with cardiorenal conditions, including chronic kidney disease (CKD), end-stage kidney disease (ESKD) or heart failure. The GALVANIZE Outcomes study compared healthcare resource use (HRU) between long-term and short-term SZC-users exactly- and propensity score-matched on key characteristics using real-world data among patients with cardiorenal conditions.

Methods

Adults with a diagnosis code for any stage CKD, ESKD, or heart failure initiating SZC in the outpatient setting from 7/2018-12/2022 were identified from a large US insurance claims database and were stratified based on duration of SZC use. Long-term SZC users (>90 days) and short-term SZC users (≤30 days) were exactly and propensity score matched on key demographic characteristics, comorbidities, treatments, and baseline HRU. Rates per person-year of HK-related hospitalizations or emergency department (ED) visits and of HK-related hospitalizations were compared during follow-up from SZC initiation (index) to the earliest of 6 months post-index, end of data availability, other potassium binder use, or re-initiation of SZC following discontinuation.

Results

Of the 2,892 included matched pairs with cardiorenal conditions, 59% were male and the mean age was 64 years. Most patients had CKD (64%) and about one-third had ESKD (35%) and heart failure (33%). Diabetes was present in almost three-quarters of patients (71%) and hypertension was common (89%). Patients with long-term SZC use had a 40% lower rate of HK-related hospitalizations or ED visits than patients with short-term SZC use during follow-up (p<0.001). Long-term SZC users also had a 37% lower rate of HK-related hospitalizations than short-term SZC users (p<0.001).

Conclusions

Among patients with cardiorenal conditions, long-term SZC use was associated with significantly lower rates of HK-related hospitalizations or ED visits than matched patients with short-term SZC use.

Funding

AstraZeneca