Pilot Study of the Effect of Lanthanum Carbonate (FosrenolÃÂ®) In Patients with Calciphylaxis: A Wisconsin Network for Health Research (WiNHR) Study
- *Corresponding Author:
- Micah R. Chan
Department of Medicine
Division of Nephrology, 3034 Fish Hatchery Rd
Suite B, Madison, WI 53713, USA
E-mail: [email protected]
Received Date: March 10, 2014; Accepted Date: May 07, 2014; Published Date: May 12, 2014
Citation: Chan MR, Ghandour F, Murali NS, WashburnMJ, Astor BC (2014) Pilot Study of the Effect of Lanthanum Carbonate (Fosrenol®) In Patients with Calciphylaxis: A Wisconsin Network for Health Research (WiNHR) Study. J Nephrol Ther 4:162. doi:10.4172/2161-0959.1000162
Copyright: © 2014 Chan MR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Currently there is a lack of effective treatment options for patients with calciphylaxis. There is anecdotal evidence that non-calcium based phosphorus binders may offer some benefit. The aim of this pilot study is to determine if lanthanum carbonate is effective in inducing remission of calciphylaxis lesions and demonstrate an improved DLQI (Dermatology Life Quality Index). Methods: This is a multi-site exploratory pilot study conducted through the Wisconsin Network for Health Research (WiNHR), a collaboration of health services researchers across the state of Wisconsin. Dialysis patients were recruited from in-center dialysis units, clinics and hospital admissions over a period of 24-months. Results: Due to the low inclusion rate, the trial was terminated after which 4 patients were prospectively analyzed. Dose of lanthanum carbonate was escalated to 3750 mg divided into 3 meals and titrated according to level of serum phosphorus. Gastrointestinal symptoms were the most common adverse effect. All 4 patients achieved complete remission by definition of skin re-epithelialization. Secondary outcome measurements showed a significant improvement in serum albumin (B coeff 0.17, 95% CI 0.002-0.031; p=0.023) and a significant improvement in overall DLQI score (B coeff -0.46, 95% CI -0.85- -0.08; p=0.019). Conclusions: Lanthanum carbonate appears to be efficacious as an adjunctive therapy to improve calciphylaxis lesions and symptom burden. More prospective clinical trials are warranted to determine the feasibility of this novel treatment strategy.