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Micah R Chan, Fadi Ghandour, Narayana S Murali, Mj Washburn, Brad C Astor
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...
May 14, 2014: Journal of Nephrology & Therapeutics
Michael Lanz, Jan Baldischweiler, Burkhard Kriwet, Jutta Schill, John Stafford, Georgios Imanidis
The official Pharmacopeia does not include a test procedure for the in vitro estimation of the chewability of tablets and publications in the scientific literature on this subject are rare. The purpose of this study was to evaluate a number of different test procedures for assessing chewability, starting from standard breaking force and strength testing and progressing to develop new procedures that simulate the actual chewing action on tablets. A further goal was to apply these test procedures to characterize the chewability of the novel phosphate binder PA21 in comparison with a commercially available phosphate binder chewable tablet product based on lanthanum (Fosrenol®) and a chewable tablet product containing calcium (Calcimagon®) - the latter being used as a standard for its very good chewability...
December 2014: Drug Development and Industrial Pharmacy
M D Bull, R Shrimanker, M R M Thomas, C J Mulgrew
A 69-year-old male was referred from the renal unit to radiology for investigation of bleeding per rectum. A CT mesenteric angiogram was performed. However, it was noted on the pre-contrast images that the large bowel contained positive oral contrast media. The procedure was abandoned as it would have been difficult to see extravasation of intravenous contrast from a bleeding point in the large bowel. The initial belief was that either the patient had been given oral contrast by ward staff on the assumption that it would be needed, or had had a recent radiological study requiring contrast, which was still present...
April 2012: British Journal of Radiology
Nirupama Vemuri, Michael F Michelis, Albert Matalon
BACKGROUND: Lanthanum carbonate (FOSRENOL®) is an effective, well-tolerated phosphate binder. The ability of lanthanum to reduce serum phosphorus levels to ≤5.5 mg/dL in patients with end-stage renal disease (ESRD) was assessed in a clinical practice setting. METHODS: A 16-week, phase IV study enrolled 2763 patients at 223 US sites to evaluate the efficacy of lanthanum carbonate in controlling serum phosphorus in patients with ESRD, and patient and physician satisfaction with, and preference for, lanthanum carbonate after conversion from other phosphate-binder medications...
September 30, 2011: BMC Nephrology
J Zhang, Y Li, X Hao, Q Zhang, K Yang, L Li, L Ma, S Wang, X Li
The biological properties of the lanthanides, primarily based on their similarity to calcium, have been the basis for research into potential therapeutic applications of lanthanides since the early part of the twentieth century. Up to date, cerium nitrate has been used as a topical cream with silver sulfadiazene for the treatment of burn wounds. A lanthanide texaphyrin complex (motexafin gadolinium) has been evaluated through Phase III clinical trials for the treatment of brain metastases in non-small cell lung cancer...
July 2011: Mini Reviews in Medicinal Chemistry
Stephen Damment, Roger Secker, Victor Shen, Victor Lorenzo, Mariano Rodriguez
BACKGROUND: Lanthanum carbonate (FOSRENOL(®), Shire Pharmaceuticals) is an effective non-calcium, non-resin phosphate binder for the treatment of hyperphosphataemia in patients with chronic kidney disease (CKD). In this study, we used a rat model of chronic renal failure (CRF) to examine the long-term effects of controlling serum phosphorus with lanthanum carbonate treatment on the biochemical and bone abnormalities associated with CKD-mineral and bone disorder (CKD-MBD). METHODS: Rats were fed a normal diet (normal renal function, NRF), or a diet containing 0...
June 2011: Nephrology, Dialysis, Transplantation
Hiromitsu Hayashi, Minoru Machida, Tetsuro Sekine, Hidenori Yamaguchi, Tomonari Kiriyama, Shin-Ichiro Kumita
Lanthanum carbonate hydrate is a nonaluminum, noncalcium phosphate binder containing lanthanum (La). It is effective in decreasing the serum phosphate level in patients on dialysis. Because the atomic number of the La contained in lanthanum carbonate hydrate is relatively high, at 57, this agent may cause strong artifacts on computed tomography (CT) images, which may be mistakenly interpreted as foreign bodies. We recently performed CT examination of a patient on Fosrenol chewable tablets (i.e., lanthanum carbonate hydrate)...
May 2010: Japanese Journal of Radiology
Monique P Curran, Dean M Robinson
Orally administered lanthanum carbonate (Fosrenol) dissociates in the acid environment of the upper gastrointestinal tract to release the cation lanthanum, which then binds dietary phosphate. Lanthanum carbonate was effective in reducing levels of serum phosphate and serum calcium x phosphate product and then maintaining these levels within target ranges for up to 6 years in adult patients with end-stage renal disease (ESRD) on haemodialysis or peritoneal dialysis. The reduction in serum phosphate levels with lanthanum carbonate was generally similar to that with calcium carbonate or sevelamer hydrochloride...
November 12, 2009: Drugs
R Wilson, P Zhang, M Smyth, R Pratt
OBJECTIVE: Epidemiological data link elevated levels of serum phosphorus with increased mortality among patients with chronic kidney disease. Recent data also suggest improved survival with the use of dietary phosphate binders in patients on dialysis. However, few studies have comprehensively evaluated the survival benefit associated with different phosphate binders. A post-hoc survival analysis was undertaken of lanthanum carbonate (Fosrenol *) versus standard therapy. RESEARCH DESIGN AND METHODS: Patients on dialysis enrolled in a phase 3, 2-year, comparative safety study were randomized 1:1 to lanthanum carbonate or standard therapy to treat serum phosphorus to a target of < or =5...
December 2009: Current Medical Research and Opinion
Micah R Chan, Alexander S Yevzlin, Molly Hinshaw, Jonathan B Jaffery
Calciphylaxis is a rare and debilitating vasculopathy predominantly seen in patients with renal failure. The proposed mechanism of injury is active vascular calcification with associated elevated parathyroid hormone, hypercalcemia, or hyperphosphatemia. With improved pharmacologic agents including non-calcium containing phosphate binders, vitamin D analogues, calcimimetics, and bisphosphonates, targeted therapy on the mineralization process has been tried with varied success. We report a case of biopsy-proven calciphylaxis in a patient with acute kidney injury requiring dialysis that had persistently elevated calcium-phosphorus product refractory to treatment...
November 2008: WMJ: Official Publication of the State Medical Society of Wisconsin
Stuart M Sprague, Hanna Abboud, Ping Qiu, Matthew Dauphin, Pinggao Zhang, William Finn
BACKGROUND AND OBJECTIVES: Lanthanum carbonate (FOSRENOL, Shire Pharmaceuticals) is an effective noncalcium, nonresin phosphate binder for the control of hyperphosphatemia in chronic kidney disease (CKD) stage 5 patients undergoing dialysis. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: A Phase 2, randomized, double-blind, placebo-controlled trial evaluating the efficacy and safety of lanthanum carbonate in CKD stage 3 and 4 patients. Of 281 patients screened, 121 were randomized (2:1) to lanthanum carbonate or placebo (80 versus 41)...
January 2009: Clinical Journal of the American Society of Nephrology: CJASN
V Torregrosa Prats
Lanthanum is an element belonging to the group called rare earths. Due to its low solubility, lanthanum carbonate has been widely studied as an intestinal phosphate binder. The results of different clinical trials show that it is an effective and well-tolerated phosphate binder used in monotherapy. Serum phosphate levels are controlled in approximately 70% of patients at 5 years without causing hypercalcemia. The only significant adverse effects observed are a low percentage of gastrointestinal disturbances (6%)...
2008: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
M Rodríguez Portillo
The present report describes different aspects of Fosrenol (lantahnum carbonate) which can be summarized as follows: Lanthanum shows a great binding affinity for phosphate. It is minimally absorbed by intestine and is eliminated by biliary route thus renal failure does not favour body accumulation of lanthanum. The effectiveness and safety of Fosrenol has been proven in clinical trials which have include more of 5,500 patients. Fosrenol has shown to be effective in controlling serum phosphate in short and long term studies (6 years)...
2008: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Alastair J Hutchison, M Edwina Barnett, Rolfdieter Krause, Jonathan T C Kwan, Ghodrat A Siami
BACKGROUND/AIMS: Lanthanum carbonate (LC, FOSRENOL) is an effective phosphate binder for which tolerability and a safety profile have been reported in haemodialysis patients. Patients from previous studies entered a 2-year extension, enabling assessment of efficacy and safety for up to 6 years of LC monotherapy. METHODS: Patients from four previous trials entered this study. RESULTS: Ninety-three patients started the extension, with 22 entering a sixth year of LC treatment...
2008: Nephron. Clinical Practice
Felix Bronner, Boris M Slepchenko, Michael Pennick, Stephen J P Damment
OBJECTIVE: Lanthanum carbonate (Fosrenol) is a non-calcium phosphate binder that controls hyperphosphataemia without increasing calcium intake above guideline targets. The biological fate and bone load of lanthanum were modelled with the aid of a four-compartment kinetic model, analogous to that of calcium. METHODS: The model used data from healthy subjects who received intravenous lanthanum chloride or oral lanthanum carbonate, and bone lanthanum concentration data collected from dialysis patients during three long-term trials (up to 5 years)...
2008: Clinical Pharmacokinetics
Rajnish Mehrotra, Kevin J Martin, Steven Fishbane, Stuart M Sprague, Steven Zeig, Michael Anger
BACKGROUND AND OBJECTIVES: Management of hyperphosphatemia, a predictor of mortality in chronic kidney disease, is challenging. Nonadherence to dietary phosphate binders, in part, contributes to uncontrolled serum phosphorus levels. This phase IIIb trial assessed the efficacy of increased dosages (3000 to 4500 mg/d) of reformulated lanthanum carbonate (500-, 750-, and 1000-mg tablets) in nonresponders to dosages of up to 3000 mg/d. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This 8-wk study with a 4-mo open-label extension enrolled 513 patients who were undergoing maintenance hemodialysis...
September 2008: Clinical Journal of the American Society of Nephrology: CJASN
Simon Paul Fricker
The platinum anticancer drug cisplatin has made a major contribution to the treatment of testicular and ovarian cancer. This chance discovery has been the stimulus for research into other metal-based drugs. Inorganic chemistry offers many opportunities for medicinal chemistry, and the discovery of metal-based drugs has moved on from chance discovery to rational drug design. There are however, many challenges associated with the drug discovery and development process. The aim of this review is to provide case histories exemplifying the role of rational drug design in modern inorganic medicinal chemistry in the context of these challenges...
November 21, 2007: Dalton Transactions: An International Journal of Inorganic Chemistry
Valerie Autissier, Stephen J P Damment, Richard A Henderson
The high tablet burden and poor compliance associated with phosphate-binding drugs has led to a search for more potent agents. In vitro-binding studies were performed on the recently introduced binder, lanthanum carbonate (LC; Fosrenol), to compare its phosphate-binding affinity with sevelamer hydrochloride (SH; Renagel). Langmuir equilibrium binding affinities (K(1)) for LC and SH were established using different phosphorus (5-100 mM) and binder (134-670 mg per 50 mL) concentrations at pH 3-7, with or without salts of bile acids present (30 mM)...
October 2007: Journal of Pharmaceutical Sciences
Liuxing Feng, Haiqing Xiao, Xiao He, Zijie Li, Fuliang Li, Nianqing Liu, Yuliang Zhao, Yuying Huang, Zhiyong Zhang, Zhifang Chai
Lanthanides, because of their diversified physical and chemical effects, have been widely used in a number of fields. As a result, more and more lanthanides are entering into the environment and eventually accumulated in human body. Recently, a new medicine, lanthanum carbonate (Fosrenol), has been used to treat chronic renal failure (CRF), and the dosage is much higher than the daily intake of lanthanides. However, the effects of lanthanides on human body, especially on the central nervous system, are still unclear...
August 20, 2006: Toxicology Letters
F Albaaj, A J Hutchison
Approximately 70% of patients with end-stage renal disease and dialysis have hyperphosphataemia, which is associated with renal osteodystrophy, metastatic calcification and increased mortality and morbidity. Despite dietary restriction and dialysis, most patients will require a phosphate-binding agent to treat this condition. However, phosphate control has not significantly improved over the last two decades, mainly because of the lack of an ideal phosphate-binding agent. Aluminium-based and calcium-based agents are associated with major side-effects despite their efficacy...
September 2005: International Journal of Clinical Practice
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