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CMHC PULSE

Cardio Metabolic Health Congress – Official Blog

New Treatment for Hyperkalemia Shows Promise

Hyperkalemia is a serious clinical challenge in patients with chronic cardiometabolic diseases and comorbidities, and there is currently a large unmet need for better treatments. A study just published in JAMA has shown that patients suffering from hyperkalemia and diabetic kidney disease showed significant decreases in serum potassium levels when treated with patiromer, a new drug by Relypsa Inc. awaiting FDA approval later this year. (Only one FDA-approved treatment option for hyperkalemia currently exists.) These decreases in potassium were evident after only 4 weeks of treatment, and, importantly, lasted 52 weeks afterward. Dr. George L. Bakris, a professor of medicine at the University of Chicago who led the study, will be chairing the 10th Annual Cardiometabolic Health Congress sessions and the CME symposium, “New Insights into the Prevention and Clinical Management of Hyperkalemia,” being held in Boston October 21-24, 2015. Hyperkalemia, characterized by dangerously high potassium levels, is potentially life threatening and most often seen in patients treated with RAAS inhibitors who have stage 3 or greater chronic kidney disease who may also have diabetes, heart failure, or both.

Advances in Heart Failure
Also of note, the first of a new class of drugs known as angiotensin receptor neprolysin inhibitors (ARNIs) has received FDA approval for patients with heart failure after showing a significant mortality benefit compared with an ACE inhibitor. Dr. Clyde W. Yancy will be speaking about this eagerly awaited new option and other novel HF therapies at the 10th Annual CMHC, joining an expert panel on Friday, October 23.

Reference: Bakris GL, et al. Effect of patiromer on serum potassium level in patients with hyperkalemia and diabetic kidney disease. The AMETHYST-DN Randomized Clinical Trial. JAMA. 2015;314:151-161.

GLP-1 Agonist Liraglutide Significantly Decreases CV Risk and Mortality: Full Results From LEADER Presented

The GLP-1 agonist liraglutide has been shown to significantly decrease the risk of major cardiovascular events and death from any cause over a 3-year period: a 13% relative risk reduction, when compared with placebo as add-on therapy, according to results from the LEADER trial presented at the annual meeting of the American Diabetes Association (ADA). Other findings include a 15% reduction in all-cause mortality and a 22% reduction in cardiovascular death during follow-up. Therapy with liraglutide was also associated with a significant 22% reduction in the time to a first renal event, which was a secondary endpoint.

More than 9000 patients were enrolled in LEADER, with more than 4400 assigned to liraglutide plus standard of care and the remaining assigned to placebo plus standard of care. Patients were treated for a median of 3.8 years.

CMHC Chair Robert Eckel, MD, who moderated the ADA press conference during which results were reported, indicated although LEADER is a complicated study, it may have an impact on practice. Speaking about the treatment algorithm when patients don’t reach HbA1c goals on metformin, Dr. Eckel said, “With EMPA-REG, published a year ago, and now with LEADER, we have to think beyond metformin as to what that second drug of choice might be. With LEADER we already have a hint that there may be another drug in this class that appears to be beneficial.”

For more insight and expert perspective, plan to attend the 11th Annual Cardiometabolic Health Congress, taking place this October 5-8, 2016 in Boston, MA, which will further explore the clinical implications of the results of CV outcomes trials including LEADER and EMPA-REG.

References:

Marso et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. June 13, 2016DOI: 10.1056/NEJMoa1603827.

MedPage Today. ADA: Liraglutide reduces risk risk of heart events. June 13, 2016.