Impact on hospitalizations of long-term versus short-term therapy with sodium zirconium cyclosilicate during routine outpatient care of patients with hyperkalemia: the recognize I study

ABSTRACT

Background

Hyperkalemia is associated with increased healthcare resource utilization (HRU). This study evaluated the impact of sodium zirconium cyclosilicate (SZC) use on HRU in outpatients with hyperkalemia.

Research design and methods

A retrospective noncomparative study using claims data from the HealthVerity warehouse, which included outpatients in the United States who initiated SZC between January and December 2019 (index date) with ≥6 months’ continuous coverage before (baseline) and after (follow-up) the index date (total coverage of 12 months). The study aimed to describe HRU with long-term and short-term SZC (defined as >90 and ≤90 days’ supply, respectively, during 180 days’ follow-up) and identify characteristics associated with long-term versus short-term therapy.

Results

Of 1153 patients, 748 (64.9%) received short-term and 405 (35.1%) received long-term therapy. During follow-up, lower proportions of patients on long-term versus short-term therapy had hyperkalemia-related hospitalizations (10.1% vs 15.1%; P < 0.05) and all-cause hospitalizations (22.5% vs 29.3%; P < 0.05). Hyperkalemia-related and all-cause hospitalization proportions were 33.0% and 23.3% lower, respectively. Predictors of long-term therapy included stage 3 chronic kidney disease.

Conclusions

Approximately one-third of patients with hyperkalemia received long-term SZC therapy. Hyperkalemia-related and all-cause hospitalization proportions were lower with long-term therapy, although further confirmatory studies are needed.

KEYWORDS:

• Hospitalization
• hyperkalemia
• outpatient care
• real-world evidence
• sodium zirconium cyclosilicate

Acknowledgments

Sarah Greig, PhD (Auckland, NZ) and Raewyn M. Poole (Philadelphia, PA, USA) of inScience Communications provided medical writing support funded by AstraZeneca.

Declaration of interest

C Pollack, Jr has acted as a scientific consultant for AstraZeneca. A Agiro and Y Brahmbhatt are employees and stockholders of AstraZeneca. F Mu, E Cook, and K Betts are employees of Analysis Group, an economic consulting firm, which received funding from AstraZeneca for the conduct of this study; E Wirtz and J Young were employees of Analysis Group at the time this study was conducted. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

One peer reviewer declares: consultant and holds stock options in Vifor (patiromer). Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Author contributions

Study conception and design: C Pollack Jr, A Agiro, F Mu, E Cook, E Wirtz, J Young, K Betts, Y Brahmbhatt. Analysis: F Mu, E Cook, E Wirtz, J Young, K Betts. Interpretation of data: C Pollack Jr, A Agiro, F Mu, E Cook, E Wirtz, J Young, K Betts, Y Brahmbhatt. Drafting of the paper or revising it for critical intellectual content: C Pollack Jr, A Agiro, F Mu, E Cook, E Wirtz, J Young, K Betts, Y Brahmbhatt. Final approval of the version to be published: C Pollack Jr, A Agiro, F Mu, E Cook, E Wirtz, J Young, K Betts, Y Brahmbhatt. All authors (C Pollack Jr, A Agiro, F Mu, E Cook, E Wirtz, J Young, K Betts, Y Brahmbhatt) agree to be accountable for all aspects of the work.

Prior presentation

Abiy Agiro, Esteban Lemus Wirtz, Joshua A. Young Impact on hospitalizations of long-term versus short-term sodium zirconium cyclosilicate therapy during routine care for patients with hyperkalemia: RECOGNIZE I. Virtual poster presentation at the NKF 2022 Spring Clinical Meeting, April 6–10, 2022, Boston, MA + virtual meeting.

Ethical conduct of research

As this study utilized de-identified data, no institutional review board waiver of informed consent approval or exemption was required, as per article 45 §CFR 164.514(e).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2161514

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The RECOGNIZE I study was supported by AstraZeneca.