Evidence map›Paper›PMID 39159624›Full record

Trial reportAmerican journal of nephrology2024

Patiromer-Facilitated Renin-Angiotensin-Aldosterone System Inhibitor Utilization in Patients with Heart Failure with or without Comorbid Chronic Kidney Disease: Subgroup Analysis of DIAMOND Randomized Trial.

Matthew R Weir, Patrick Rossignol, Bertram Pitt, Lars H Lund, Andrew J S Coats, Gerasimos Filippatos, Amandine Perrin, Sandra Waechter, Jeffrey Budden, Mikhail Kosiborod and 14 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03888066 (A Multicenter, Double-blind, Placebo-controlled, Randomized Withdrawal, Parallel Group Study of Patiromer for the Management of Hyperkalemia in Subjects Receiving Renin Angiotensin Aldosterone System Inhibitor), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT03888066 phase3completednot on this map

A Multicenter, Double-blind, Placebo-controlled, Randomized Withdrawal, Parallel Group Study of Patiromer for the Management of Hyperkalemia in Subjects Receiving Renin Angiotensin Aldosterone System Inhibitor (RAASi) Medications for the Treatment of Heart Failure (DIAMOND)

TypeinterventionalSponsorVifor Pharma, Inc.Ran2019 to 2021Enrolled1,195ConditionsHyperkalemiaArmsPatiromer, Placebos
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Review
  3. Observational
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Matthew R WeirDivision of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Patrick RossignolINSERM CIC-P 1433, CHRU de Nancy, INSERM U1116, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Université de Lorraine, Nancy, France.
Bertram PittDivision of Cardiology, University of Michigan, Ann Arbor, Michigan, USA.
Lars H LundDepartment of Medicine, Unit of Cardiology, Karolinska Institutet, Solna, Sweden.
Andrew J S CoatsHeart Research Institute, Sydney, New South Wales, Australia.
Gerasimos FilippatosSchool of Medicine, Athens University Hospital Attikon, National and Kapodistrian University of Athens, Haidari, Greece.
Amandine PerrinCSL Vifor, Glattbrugg, Switzerland.
Sandra WaechterCSL Vifor, Glattbrugg, Switzerland.
Jeffrey BuddenCSL Vifor, Redwood City, California, USA.
Mikhail KosiborodDepartment of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri, USA.
Marco MetraCardiology, ASST Spedali Civili and University, Brescia, Italy.
Michael BoehmKlinik für Innere Medizin III, Saarland University, Homburg, Germany.
Justin A EzekowitzDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Antoni Bayes-GenisCardiology Department, Hospital Universitari Germans Trias i Pujol, CIBERCV, Barcelona, Spain.
Robert J MentzDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Piotr PonikowskiInstitute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Michele SenniCardiovascular Department, ASST Papa Giovanni XXIII Hospital, University of Milano - Bicocca, Bergamo, Italy.
Eliodoro Castro-MontesInstituto de Corazon de Queretaro (ICQ), Faculty of Medicine Universidad Autonoma de Queretaro, Santiago de Queretaro, Mexico.
Jose Carlos NicolauInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
Alexandr ParkhomenkoInstitute of Cardiology, Clinical and Regenerative Medicine, Kyiv, Ukraine.
Petar SeferovicUniversity of Belgrade - Faculty of Medicine, Serbian Academy of Sciences and Arts, Belgrade, Serbia.
Alain Cohen-SolalUniversité de Paris, INSERM U942, APHP, Hospital Lariboisiere, Paris, France.
Stefan D AnkerInstitute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Javed ButlerDivision of Cardiology, University of Michigan, Ann Arbor, Michigan, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRenin-angiotensin-aldosterone system inhibitor (RAASi; including mineralocorticoid receptor antagonists [MRAs]) benefits are greatest in patients with heart failure with reduced ejection fraction (HFrEF) and chronic kidney disease (CKD); however, the risk of hyperkalemia (HK) is high.

methodsThe DIAMOND trial (NCT03888066) assessed the ability of patiromer to control serum potassium (sK+) in patients with HFrEF with/without CKD. Prior to randomization (double-blind withdrawal, 1:1), patients on patiromer had to achieve ≥50% recommended doses of RAASi and 50 mg/day of MRA with normokalemia during a run-in period. The present analysis assessed the effect of baseline estimated glomerular filtration rate (eGFR) in subgroups of ≥/<60, ≥/<45 (prespecified), and ≥/<30 mL/min/1.73 m2 (added post hoc).

resultsIn total, 81.3, 78.9, and 81.1% of patients with eGFR <60, <45, and <30 mL/min/1.73 m2 at screening achieved RAASi/MRA targets. A greater efficacy of patiromer versus placebo to control sK+ in patients with more advanced CKD was reported (p-interaction ≤ 0.027 for all eGFR subgroups). Greater effects on secondary endpoints were observed with patiromer versus placebo in patients with eGFR <60 and <45 mL/min/1.73 m2. Adverse effects were similar between patiromer and placebo across subgroups.

conclusionPatiromer enabled use of RAASi, controlled sK+, and minimized HK risk in patients with HFrEF, with greater effect sizes for most endpoints noted in patient subgroups with lower eGFR. Patiromer was well tolerated by patients in all eGFR subgroups.

Indexed as

Glomerular Filtration RateHeart FailureHyperkalemiaMineralocorticoid Receptor AntagonistsPolymersRenal Insufficiency, ChronicRenin-Angiotensin SystemAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsDouble-Blind MethodFemaleHumansMaleMiddle AgedPotassiumAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsMineralocorticoid Receptor AntagonistspatiromerPolymersPotassiumAdverse effectsAdverse eventsChronic kidney diseaseDIAMOND trialHyperkalemiaMineralocorticoid receptor antagonistRenin-angiotensin-aldosterone system inhibitors (RAASis)

Identifiers

PMID39159624
PMCPMC11651233

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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.