Ferric citrate spans mineral metabolism and anemia domains in ESRD: a review of efficacy and safety data

Abstract

Ferric citrate (Zerenex™, Keryx Biopharmaceuticals, Inc.), a phosphate binder drug candidate, recently completed a Phase III program confirming efficacy and demonstrating safety when used to treat hyperphosphatemia in patients with end-stage renal disease. Results of these trials demonstrate that ferric citrate effectively controls serum phosphorus and is well tolerated. Additionally, these studies demonstrate that ferric citrate improves iron parameters and reduces IV iron and erythropoietin stimulating agent utilization while maintaining hemoglobin levels. These unique features may further benefit the management of end-stage renal disease-related anemia.

Keywords::

• anemia
• end-stage renal disease
• metabolic bone disease

Financial & competing interests disclosure

M Sinsakul, R Rodby, K Umanath and JP Dwyer received research support from Keryx Biopharmaceuticals, Inc. to design, conduct and/or analyze the trials discussed herein. R Niecestro acted as an independent consultant to the design, conduct and analysis of the trials discussed hereinand was funded by Keryx Biopharmaceuticals, Inc. 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.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Renal-associated metabolic bone disease and anemia are serious complications of end-stage renal disease that contribute significantly to morbidity and mortality.

• Phosphate binders play a key role in the management of metabolic bone disease, but each has its own limitations.

• Ferric citrate has been shown to be a safe and effective phosphate binder and have a positive effect on the management of anemia in end-stage renal disease.

• The decrease in intravenous iron and erythropoietin stimulating agent utilization associated with ferric citrate may reduce the overall cost of managing patients with end-stage renal disease.