Getting to goal—with potency

Maintaining serum phosphorus levels <5.5 mg/dL is critical for patients on dialysis. However, 2010-2018 DOPPS analyses showed that little progress had been made.1,2

Getting to goal - with potency Getting to goal - with potency
  • 2/3 of patients are still beyond the normal range2

  • More than 4 out of 10 remain above KDOQI goals1-3

  • 85%-90% of patients are taking sevelamer or calcium-based phosphate binders2

  • 50% of patients taking 9+ phosphate binder pills per day are not at goal5


The power of 1 tablet

  • Binds up to 130 mg of phosphorus, the most of any binder6,7

  • Binds up to 96% of available phosphate8

  • Is 2.5X as powerful as one tablet of sevelamer7

*In vitro study. Assumes 0.26 mg of P are bound by 1 mg of Fe. Based on a typical P-restricted diet of ±900 mg of P/day.6

In vitro study. Comparison among phosphate binders on a gram-to-gram basis.7

‡ A 52-week, open-label, active-controlled, phase 3 study evaluated the safety and efficacy of Velphoro in lowering serum phosphorus levels in patients (N=1,054) with chronic kidney disease on hemodialysis or peritoneal dialysis. In the titration phase (first 24 weeks), patients were randomized to receive either Velphoro or sevelamer carbonate to establish the noninferiority of Velphoro to sevelamer carbonate in lowering serum phosphorus at 12 weeks (secondary endpoint). The following withdrawal phase (weeks 24 to 27, n=93) established the superiority of Velphoro with an effective maintenance dose over a placebo-like low dose (primary endpoint). During a final long-term maintenance phase (weeks 28-52, n=658), patients continued phosphate binder treatment according to their original randomization for the assessment of long-term efficacy, safety, and tolerability.8

References: 1. Dialysis Outcomes and Practice Patterns Study Program (2010). The DOPPS Practice Monitor. 2. Dialysis Outcomes and Practice Patterns Study Program. The DOPPS Practice Monitor. Accessed June 17, 2019. 3. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease. Am J Kidney Dis. 2003;42(4 suppl 3):S1-S201. 4. Kidney Disease: Improving Global Outcomes. KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int. 2009:76(suppl 113):1-140. 5. Fissell RB, Karaboyas A, Bieber BA, et al. Phosphate binder pill burden, patient-reported non-adherence, and mineral bone disorder markers: findings from the DOPPS. Hemodial Int. 2016;20(1):38-49. 6. Wilhelm M, Gaillard S, Rakov V, Funk F. The iron-based phosphate binder PA21 has potent phosphate binding capacity and minimal iron release across a physiological pH range in vitro. Clin Nephrol. 2014;81(4):251-258. 7. Gutekunst L. An update on phosphate binders: a dietitian’s perspective. J Ren Nutr. 2016;26(4):209-218. 8. Velphoro® [package insert]. Waltham, MA: Fresenius Medical Care North America: 2018. 9. Floege J, Covic AC, Ketteler M, et al; on behalf of the Sucroferric Oxyhydroxide Study Group. Long-term effects of the iron-based phosphate binder, sucroferric oxyhydroxide, in dialysis patients. Nephrol Dial Transplant. 2015;30(6):1037-1046.