LAS VEGAS—New findings confirm the phosphorus-lowering effects of extended-release niacin in fixed-dose combination with laropiprant (ERN-L) in dyslipidemic patients with stage 3 chronic kidney disease (CKD).

徐放性ナイアシン製剤とラロピラント（ナイアシンフラッシュを減らす薬剤）の併用療法が、ステージ3の慢性腎臓病かつ脂質代謝異常患者に対して用いられ、血清リン低下効果があることが確かめられれた。

 

A team led by Andrew G. Bostom, MD, of Rhode Island Hospital in Providence, evaluated the impact of the treatment compared with placebo in 261 such patients pooled from two randomized, controlled trials. Subjects had a baseline estimated glomerular filtration rate of 30-59 mL/min/1.73 m2. Patients received one tablet daily of ERN-L (1 g ERN/20 mg L) for the first four weeks and then two tablets once daily (177 patients), or matched placebo (84 patients).

アンドルーＧボストン医師らのチーム（プロバンスのRhode島病院）は、二重盲検定試験を261人に行った。推定ＧＦＲ値が30-59mL/min/1.73 m2。177人にＥＲＮ。84人にプラセボが投与された。ＥＲＮは最初の4週間は(1 g ERN/20 mg L) 。その後は(1 g ERN/20 mg L) ｘ２。　ＥＲＮ＝extended released Niacine

 

At baseline, the ERN-L group and placebo group had a mean serum phosphate level of 3.46 and 3.57 mg/dL, respectively. From weeks 12-24, the ERN-L group experienced a sustained significant 0.42 mg/dL mean decrease compared with the placebo recipients, the investigators reported at the National Kidney Foundation’s Spring Clinical Meetings.

開始前のベースライン血清リン値は3.46±3.57mg/dLで、12-14週にかけて、ナイアシン群は平均0.42mg/dL ほど低下していた。
この結果はthe National Kidney Foundation’s Spring Clinical Meetingsにて報告された。

 

The investigators concluded that their findings have therapeutic implications for the management of hyperphosphatemia as well as the possible prevention of cardiorenal outcomes in CKD among the large population of patients with stage 3 CKD. The study demonstrated that lowering phosphorus in the normal range can be achieved in stage 3 CKD patients with once-daily dosing, Dr. Bostom pointed out. This is a big advantage over the standard binder treatment requiring thrice-daily dosing, which often fails to lower phosphorus in this particular range.

研究者らは、高リン血症の治療のみならず、ステージ3腎臓病患者の心腎臓病の予防に役立つ可能性があると結論している。1日1回製剤の利用は内服継続の点で有利である。

 

“If the hypothesis that phosphorus lowering in stage 3-4 CKD patients, even if they have a relatively normal phosphorus [level], might contribute to reduction of cardiovascular disease outcomes, niacin would probably be the preferred therapy,” Dr. Bostom said.