Trial reportESC heart failure2023
Potassium reduction with sodium zirconium cyclosilicate in patients with heart failure.
Trial report in ESC heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Interdisciplinary recommendations for recurrent hyperkalaemia: insights from the GUARDIAN-HK European Steering Committee.European heart journal. Cardiovascular pharmacotherapy · 2025Guideline
- Pooled it
- The efficacy and safety of new potassium binders on renin-angiotensin-aldosterone system inhibitor optimization in heart failure patients: a systematic review and meta-analysis.ESC heart failure · 2024Pooled it
- Safety and efficacy of new potassium binders on hyperkalemia management in patients with heart failure: a systematic review and meta-analysis of randomized controlled trials.Clinical research in cardiology : official journal of the German Cardiac Society · 2023Pooled it
- Potassium reduction with sodium zirconium cyclosilicate in patients with heart failure.ESC heart failure · 2023Trial
- Hospitalization and Emergency Department Costs in Patiromer and Sodium Zirconium Cyclosilicate Users.Kidney360 · 2026Article
- Comparative effectiveness of sodium zirconium cyclosilicate versus calcium polystyrene sulfonate for patients with heart failure.Heart and vessels · 2026Article
- Improving the Analysis of KCCQ Endpoints in Heart Failure Clinical Trials.Therapeutic innovation & regulatory science · 2026Article
- [Consensus recommendations on the diagnosis and treatment of hyperkalemia of the Austrian Society of Nephrology 2026].Wiener klinische Wochenschrift · 2026Review
- Overcoming Hyperkalaemia to Optimise Heart Failure Therapy: The Emerging Role of Novel Potassium Binders.Cardiac failure review · 2026Review
- Article
- Sodium zirconium cyclosilicate for MRAs optimization in HFrEF: lessons learned from the REALIZE-K trial.Heart failure reviews · 2025Review
- Hyperkalemia management: a multidisciplinary expert panel's perspective on the role of new potassium binders.Heart failure reviews · 2025Review
- EMCREG-International Multidisciplinary Consensus Panel on Management of Hyperkalemia in Chronic Kidney Disease and Heart Failure.Cardiorenal medicine · 2025Review
- Pharmacological Therapy of HFrEF in 2025: Navigating New Advances and Old Unmet Needs in An Eternal Balance Between Progress and Perplexities.Cardiac failure review · 2025Review
- Management of patients with heart failure and chronic kidney disease.Heart failure reviews · 2024Review
- Managing hyperkalemia in patients with heart failure on guideline-directed medical therapy: challenges and opportunities.Internal and emergency medicine · 2024Article
- Aldosterone and Potassium in Heart Failure: Overcoming This Major Impediment in Clinical Practice.Cardiac failure review · 2024Review
- Impact of Sodium Zirconium Cyclosilicate Plus Renin-Angiotensin-Aldosterone System Inhibitor Therapy on Short-Term Medical Costs in Hyperkalemia: OPTIMIZE II Real-World Study.Advances in therapy · 2023Article
- Safety and efficacy of novel potassium binders for chronic hyperkalemia: a systematic review and meta-analysis of randomized controlled trials.Proceedings (Baylor University. Medical Center)Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 9 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsSeveral patients with heart failure and reduced ejection fraction (HFrEF) do not receive renin-angiotensin-aldosterone system (RAAS) inhibitors at the recommended dose or at all, frequently due to actual or feared hyperkalaemia. Sodium zirconium cyclosilicate (SZC) is an orally administered non-absorbed intestinal potassium binder proven to lower serum potassium concentrations. METHODS AND
resultsPRIORITIZE-HF was an international, multicentre, parallel-group, randomized, double-blind, placebo-controlled study to evaluate the benefits and risks of using SZC to intensify RAAS inhibitor therapy. Patients with symptomatic HFrEF were eligible and randomly assigned to receive SZC 5 g or placebo once daily for 12 weeks. Doses of study medication and RAAS inhibitors were titrated during the treatment period. The primary endpoint was the proportion of patients at 12 weeks in the following categories: (i) any RAAS inhibitor at less than target dose, and no MRA; (ii) any RAAS inhibitor at target dose and no MRA; (ii) MRA at less than target dose; and (iv) MRA at target dose. Due to challenges in participant management related to the COVID-19 pandemic, the study was prematurely terminated with 182 randomized patients. There was no statistically significant difference in the distribution of patients by RAAS inhibitor treatment categories at 3 months (P = 0.43). The proportion of patients at target MRA dose was numerically higher in the SZC group (56.4%) compared with the placebo group (47.0%). Overall, SZC was well tolerated.
conclusionsPRIORITIZE-HF was terminated prematurely due to COVID-19 and did not demonstrate a statistically significant increase in the intensity of RAAS inhibitor therapies with the potassium-reducing agent SZC compared with placebo.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.