Background and Objective <p>Patients with heart failure or cardio/renal dysfunction (chronic kidney disease, end-stage kidney disease, or heart failure) are at increased risk of hyperkalemia. Sodium zirconium cyclosilicate (SZC) treats hyperkalemia, but the impact of SZC treatment duration on healthcare resource utilization in these populations is unclear. This study, GALVANIZE Outcome, assessed healthcare resource utilization associated with short-term versus long-term outpatient SZC use in matched cohorts of SZC users with heart failure and, separately, cardio/renal dysfunction.</p> Methods <p>Data from a large US claims database (7/2018–12/2022) were used to identify adults with heart failure or cardio/renal dysfunction initiating outpatient SZC (index date). Long-term (&gt;&#xa0;90 days) and short-term SZC users (≤&#xa0;30 days) were matched on key baseline characteristics using a two-step approach: exact matching followed by propensity score matching. Rates of hyperkalemia-related hospitalizations or emergency department visits and hyperkalemia-related hospitalizations were compared between long-term and short-term SZC users during the follow-up from index to the earliest of 6 months post-index, end of data availability, new potassium binder use, or reinitiation of SZC post-discontinuation.</p> Results <p>Among 942 matched heart failure pairs and 2892 matched cardio/renal pairs, long-term SZC users had fewer hyperkalemia-related hospitalizations or emergency department visits compared with short-term users, with reductions of 36% in the heart failure sample and 40% in the cardio/renal dysfunction sample; the respective reductions were 39% and 37% for hyperkalemia-related hospitalizations alone (all <i>p</i> &lt; 0.001).</p> Conclusions <p>Long-term SZC use is associated with significant reductions in hyperkalemia-related hospitalizations or emergency department visits compared with short-term use among patients with heart failure or cardio/renal dysfunction.</p> Graphical Abstract <p>The GALVANIZE Outcome RWE study was a comparison of HK-related HRU between matched long-term (&gt; 90 days) and short-term (≤ 30 days) SZC users with heart failure or cardio/renal dysfunction (CKD, ESKD, or heart failure) using real-world data from HealthVerity spanning 7/2018–12/2022. Adult patients with heart failure or cardio/renal dysfunction and long-term outpatient SZC use had significantly lower rates of HK-related hospitalizations or ED visits, HK-related hospitalizations and HK-related ED visits than exactly and propensity-score matched patients with short-term outpatient SZC use. Abbreviations: CI, confidence interval; CKD, chronic kidney disease; ED, emergency department; ESKD, end-stage kidney disease; HK, hyperkalemia; HRU, healthcare resource utilization; RWE, real world evidence; SZC, sodium zirconium cyclosilicate</p> <p></p>

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Sodium Zirconium Cyclosilicate Duration and Hyperkalemia-Related Healthcare Encounters in Patients with Heart Failure and Cardio/Renal Dysfunction: The GALVANIZE Outcome Study

  • Abiy Agiro,
  • Fan Mu,
  • Erin E. Cook,
  • Ali Greatsinger,
  • Jingyi Chen,
  • Manasvi Sundar,
  • Angela Zhao,
  • Ellen Colman,
  • Arun Malhotra

摘要

Background and Objective

Patients with heart failure or cardio/renal dysfunction (chronic kidney disease, end-stage kidney disease, or heart failure) are at increased risk of hyperkalemia. Sodium zirconium cyclosilicate (SZC) treats hyperkalemia, but the impact of SZC treatment duration on healthcare resource utilization in these populations is unclear. This study, GALVANIZE Outcome, assessed healthcare resource utilization associated with short-term versus long-term outpatient SZC use in matched cohorts of SZC users with heart failure and, separately, cardio/renal dysfunction.

Methods

Data from a large US claims database (7/2018–12/2022) were used to identify adults with heart failure or cardio/renal dysfunction initiating outpatient SZC (index date). Long-term (> 90 days) and short-term SZC users (≤ 30 days) were matched on key baseline characteristics using a two-step approach: exact matching followed by propensity score matching. Rates of hyperkalemia-related hospitalizations or emergency department visits and hyperkalemia-related hospitalizations were compared between long-term and short-term SZC users during the follow-up from index to the earliest of 6 months post-index, end of data availability, new potassium binder use, or reinitiation of SZC post-discontinuation.

Results

Among 942 matched heart failure pairs and 2892 matched cardio/renal pairs, long-term SZC users had fewer hyperkalemia-related hospitalizations or emergency department visits compared with short-term users, with reductions of 36% in the heart failure sample and 40% in the cardio/renal dysfunction sample; the respective reductions were 39% and 37% for hyperkalemia-related hospitalizations alone (all p < 0.001).

Conclusions

Long-term SZC use is associated with significant reductions in hyperkalemia-related hospitalizations or emergency department visits compared with short-term use among patients with heart failure or cardio/renal dysfunction.

Graphical Abstract

The GALVANIZE Outcome RWE study was a comparison of HK-related HRU between matched long-term (> 90 days) and short-term (≤ 30 days) SZC users with heart failure or cardio/renal dysfunction (CKD, ESKD, or heart failure) using real-world data from HealthVerity spanning 7/2018–12/2022. Adult patients with heart failure or cardio/renal dysfunction and long-term outpatient SZC use had significantly lower rates of HK-related hospitalizations or ED visits, HK-related hospitalizations and HK-related ED visits than exactly and propensity-score matched patients with short-term outpatient SZC use. Abbreviations: CI, confidence interval; CKD, chronic kidney disease; ED, emergency department; ESKD, end-stage kidney disease; HK, hyperkalemia; HRU, healthcare resource utilization; RWE, real world evidence; SZC, sodium zirconium cyclosilicate