Less of the same—PA21 can reduce pill burden in patients with hyperphosphataemia

Patients with chronic kidney disease (CKD) often develop hyperphosphataemia, which can lead to bone mineral disease, cardiovascular problems and, eventually, death. Although phosphate-binding drugs are used to control serum phosphorous levels, patients are often required to take a high number of pills—which can reduce patient adherence. Indeed, reducing dependence on medication can not only improve quality of life, but also increase the likelihood of a patient continuing their treatment. A phase III trial, reported in Kidney International, now shows that the phosphate binder PA21 (sucroferric oxyhydroxide) is equally effective as the commonly used sevelamer carbonate for maintaining phosphate levels, but crucially does so with fewer pills.