Introduction

Patiromer (trade name: Veltassa) has been approved in Germany since July 2017 for the treatment of hyperkalemia in adults.

In hyperkalemia, blood potassium levels are too high. Potassium is found in various foods. It plays an important role in maintaining essential physical processes in the body. These include the normal activity of nerves and muscles, as well as the regulation of the balance of fluids.

If the kidneys don’t flush out enough potassium, potassium levels rise. Several things can cause this to happen: diseases such as chronic kidney failure, adrenal insufficiency (Addison's disease), or various medications – especially those for the treatment of heart failure or high blood pressure. While a slight increase usually won’t cause any problems, very high levels of potassium can be fatal. Symptoms include muscle weakness and even paralysis or arrhythmia.

The drug patiromer binds potassium in the gastrointestinal (stomach and bowel) tract in order to decrease blood potassium levels.

Application

Patiromer is available as a powder in three different doses:

  • 8.4 g
  • 16.8 g
  • 25.2 g

The powder is mixed with about 80 ml of water, apple juice or cranberry juice, and taken with a meal. The recommended dose at the start of treatment is 8.4 g per day. Depending on blood potassium levels, the dose can be increased up to 25.2 g daily. The powder should not be used within three hours of taking other medication.

Other treatments

Several treatments are available for patients with hyperkalemia. The treatment will depend on various factors such as underlying diseases, whether it is an initial treatment or which treatments have been tried before. A change in diet may also be an option. The treatment is individually adjusted by the doctor.

Assessment

In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether patiromer has any advantages or disadvantages in adults with hyperkalemia when compared with individually optimized treatment.

But the manufacturer did not provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of this review and the hearings received, the G-BA passed a resolution on the added benefit of patiromer (Veltassa).