Considerations about the effectiveness and cost effectiveness of therapies in the treatment of hyperphosphataemia
Creators: name: Plagemann, Thomas
name: Prenzler, Anne
name: Mittendorf, Thomas
Publisher: name: Heidelberg : Springer Verlag
Year: 2011
Subjects: subject: aluminum hydroxychloride
subject: calci gry
subject: calcium
subject: calcium acetate
subject: calcium acetate plus magnesium carbonate
subject: calcium based phosphate binding agent
subject: calcium carbonate
subject: calciumacetat nefro
subject: calciumacetat prorenal am
subject: cc nefro
subject: dreisacarb
subject: lanthanum carbonate
subject: magnesium
subject: miscellaneous drugs and agents
subject: osvaren
subject: phos ex
subject: phosphate
subject: phosphate binding agent
subject: sevelamer
subject: sevelamer carbonate
subject: unclassified drug
subject: absence of side effects
subject: aluminum overload
subject: anemia
subject: blood vessel calcification
subject: calcium blood level
subject: cardiovascular disease
subject: cost benefit analysis
subject: cost effectiveness analysis
subject: drug cost
subject: drug efficacy
subject: drug safety
subject: drug tolerability
subject: gastrointestinal symptom
subject: human
subject: hypercalcemia
subject: hyperphosphatemia
subject: hypophosphatemia
subject: magnesium blood level
subject: medication compliance
subject: monotherapy
subject: osteomalacia
subject: patient compliance
subject: perception disorder
subject: phosphate blood level
subject: priority journal
subject: quality of life
subject: review
subject: risk factor
subject: risk reduction
subject: systematic review
subject: Dewey Decimal Classification::300 | Sozialwissenschaften, Soziologie, Anthropologie::330 | Wirtschaft
subject: Dewey Decimal Classification::600 | Technik::610 | Medizin, Gesundheit

description: Because of an elevated serum phosphate level, patients who suffer from chronic kidney failure frequently tend to have cardiovascular calcification and are therefore exposed to a higher probability of a fatal event. Phosphate binders are able to reduce these negative effects. Currently, there are primarily two groups of phosphate binders (calcium-containing and calcium-free phosphate binders) which are considered to be almost equally effective in terms of binding of free phosphate. There are, however, a few disadvantages of the two groups. While the calcium-containing binders are associated with an increased risk of hypercalcaemia, which is dose dependent, calcium-free binders have been criticized as being too expensive. As the expenditure for patients suffering from chronic kidney failure increases from year to year, as a result of increasing prevalence, there is a growing need for an alternative to existing phosphate binders. The study presented here therefore summarizes available information for the novel combination preparation OsvaRen® (calcium acetate/magnesium carbonate) as an alternative therapy to the calcium-free phosphate binder Renagel® (sevelamer-hydrochloride) and to calcium-containing preparations. The results of this systematic review showed that OsvaRen® is at least equally effective in the regulation of serum phosphate level as Renagel®. In particular, OsvaRen® shows no clinically relevant difference in terms of the control of the serum calcium levels compared to Renagel® and thereby does not increase the risk of a hypercalcaemia, in contrast to pure calcium-based phosphate binders. On the other hand, Renagel® therapy is much more frequently associated with gastrointestinal side-effects, a tendency to result in higher tablet burden for patients and high medication costs. The CALMAG study showed that OsvaRen® was at least as effective and safe in terms of controlling serum phosphate and serum calcium levels as Renagel® while, at the same time, resulting in about 80% lower costs. In addition, OsvaRen® offers a lower risk of hypercalcaemia and associated subsequent costs and is thereby also superior to pure calcium-containing phosphate binders. Because of the effectiveness and tolerability of calcium acetate/magnesium carbonate, OsvaRen® offers a clinically suitable and, at the same time, cost-effective therapeutic option in the therapy of hyperphosphataemia.