Skip to main content
SpringerLink
Log in

Lanthanum Carbonate

  • Adis Drug Profile
  • Published:
Drugs Aims and scope Submit manuscript

Abstract

  • ▴ Lanthanum carbonate is a novel, non-aluminium, non-calcium phosphate binding agent that forms a water-insoluble compound, lanthanum phosphate, in the gut.

  • ▴ Lanthanum carbonate (elemental lanthanum 375—3000 mg/day) reduced serum phosphorus levels compared with placebo in two randomised, double-blind, multicentre 4-week trials in patients with chronic renal failure receiving regular haemodialysis.

  • ▴ In two large, randomised trials in patients with chronic renal failure requiring haemodialysis, lanthanum carbonate (elemental lanthanum 375–3000 mg/day) was as effective as calcium carbonate and/ or other conventional phosphate binders in reducing and maintaining serum phosphorus levels (≤5.6 mg/ dL over 6 months and ≤5.9 mg/dL over 2 years).

  • ▴ Lanthanum carbonate was generally well tolerated. Most adverse events were mild-to-moderate in severity, with gastrointestinal events being the most common.

  • ▴ The tolerability profile of lanthanum carbonate was similar to those of conventional phosphate binders; however, hypercalcaemic episodes occurred significantly less frequently over 6 months with lanthanum carbonate than with calcium carbonate.

  • ▴ In a randomised 1-year trial, numerically fewer lanthanum carbonate (elemental lanthanum ≤3750 mg/day) recipients had renal bone disease at study end than at baseline; however, in the calcium carbonate ≤9000 mg/day group, numerically more patients had renal bone disease at study end compared with baseline.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Notes

  1. The data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the US Government.

  2. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. Albaaj F, Hutchison A. Hyperphosphataemia in renal failure: causes, consequences and current management. Drugs 2003; 63(6): 577–96

    Article  PubMed  Google Scholar 

  2. The Renal Association. Treatment of adults and children with renal failure [online]. Available from URL: http://www.renal.org/Standards/RenalStandSummO2.pdf [Accessed 2003 Aug 5]

  3. National Kidney Foundation. NKF K/DOQI Clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification [online]. Available from URL: http://www.kidney.org/professionals/doqi/kdoqi/toc.htm [Accessed 2003 Sep 1]

  4. U.S. Renal Data System. USRDS 2003 Annual Data Report: Atlas of end-stage renal disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD [online]. Available from URL: http://www.usrds.org/adr.htm [Accessed 2003 Sep 1]

  5. Levin NW, Hoenich NA. Consequences of hyperphosphatemia and elevated levels of the calcium-phosphorus product in dialysis patients. Curr Opin Nephrol Hypertens 2001 Sep; 10(5): 563–8

    Article  PubMed  CAS  Google Scholar 

  6. Malluche HH, Mawad H. Management of hyperphosphataemia of chronic kidney disease: lessons from the past and future directions. Nephrol Dial Transplant 2002 Jul; 17(7): 1170–5

    Article  PubMed  Google Scholar 

  7. Indridason OS, Quarles LD. Hyperphosphatemia in end-stage renal disease. Adv Ren Replace Ther 2002 Jul; 9(3): 184–92

    Article  PubMed  Google Scholar 

  8. Locatelli F, D’Amico M. Lanthanum carbonate AnorMED. Curr Opin Cardiovasc Pulmon Renal Invest Drugs 2000; 2(4): 372–7

    CAS  Google Scholar 

  9. Loghman-Adham M. Safety of new phosphate binders for chronic renal failure [published erratum appears in Drug Saf 2004; 27 (3): 213]. Drug Saf 2003; 26(15): 1093–115

    Article  PubMed  CAS  Google Scholar 

  10. Hutchison AJ, Speake M, Dewberry K, et al. Lanthanum carbonate: a novel non-calcium-containing phosphate binder in CAPD patients [abstract no. O]. Perit Dial Int 1998; 18 Suppl. 2: S38

    Google Scholar 

  11. Stewart J. Administration of a novel phosphate binder, Fosrenol™, with food is associated with good tolerability and low systemic absorption [abstract no. SAP0601]. J Am Soc Nephrol 2002; 13 Suppl.: 386A. Plus poster presented at the 35th Annual Meeting and Scientific Exposition of the American Society of Nephrology; 2002 Nov 1–4; Philadelphia

    Google Scholar 

  12. Behets GJ, Bervoets A, Oste L, et al. Time course and reversibility of the mineralisation defect induced by lanthanum carbonate in chronic renal failure rats [abstract no. F-PO657]. J Am Soc Nephrol 2003 Nov; 14 Suppl.: 205A

    Article  Google Scholar 

  13. Damment SJP, Greaves P, Downes N. The toxicology of lanthanum carbonate (Fosrenol®), a new non-aluminum, non-calcium phosphate binder [abstract no. F-PO651]. J Am Soc Nephrol 2003 Nov; 14 Suppl.: 204A. Plus poster presented at the 36th Annual Meeting and Scientific Exposition of the American Society of Nephrology; 2003 Nov 14–17; San Diego

    Google Scholar 

  14. Damment SJP, Totten W. The pharmacology of a new phosphate binder, lanthanum carbonate [abstract no. W429]. Nephrol Dial Transplant 2003; 18 Suppl. 4: 683. Plus poster presented at the 40th ERA-EDTA World Congress of Nephrology; 2003 Jun 8–12; Berlin

    Google Scholar 

  15. Dewberry K, Fox JS, Curtis CG, et al. Lanthanum carbonate an effective inhibitor of phosphate absorption from the intestinal tract [abstract]. Nephrol Dial Transplant 1997; 12(9): A98

    Google Scholar 

  16. Behets G, Bervoets A, Dams G, et al. Effects of lanthanum and strontium on osteoblasts in chronic renal failure rats [abstract no. W430]. Nephrol Dial Transplant 2003; 18 Suppl. 4: 683

    Google Scholar 

  17. Damment S, Shen V, Webster I. Phosphate supplementation normalizes changes in bone mineralization in uraemic rats given high doses of lanthanum carbonate [abstract no. W431]. Nephrol Dial Transplant 2003; 18 Suppl. 4: 684

    Google Scholar 

  18. Sack M. Fosrenol™ (lanthanum carbonate) is well tolerated in patients requiring hemodialysis: results of a phase I clinical trial [abstract no. SA-P0602]. J Am Soc Nephrol 2002; 13 Suppl.: 386A. Plus poster presented at the 35th Annual Meeting and Scientific Exposition of the American Society of Nephrology; 2002 Nov 1–4; Philadelphia

    Google Scholar 

  19. Fiddler G, Webster I. Lanthanum carbonate does not affect the pharmacokinetics of warfarin [abstract no. 25]. Am J Kidney Dis 2003 Apr; 41(4): A18

    Google Scholar 

  20. Fiddler G, Taubel J. Lanthanum carbonate (Fosrenol™) does not affect the pharmacokinetics of concomitant treatment with digoxin [abstract no. 26]. Am J Kidney Dis 2003 Apr; 41(4): A18

    Google Scholar 

  21. Fiddler G, Täubel J. No pharmacokinetic interaction between lanthanum carbonate and metoprolol [abstract no. 27]. Am J Kidney Dis 2003 Apr; 41(4): A18

    Google Scholar 

  22. Fiddler G, Tanaka T, Webster I. Low systemic absorption and excellent tolerability during administration of lanthanum carbonate (Fosrenol™) for 5 days [poster]. 9th Asian Pacific Congress of Nephrology; 2003 Feb 16–20; Pattaya, Thailand

  23. Stewart AJ. Fosrenol™ — a novel non-calcium, non-aluminium phosphate binder — is well tolerated when given during or after food intake [abstract no. PUB397]. J Am Soc Nephrol 2002; 13 Suppl.: 751A

    Google Scholar 

  24. Finn W, Joy M, Webster I, et al. Lanthanum carbonate (Fosrenol™) causes significant reductions in serum phosphorus and Ca × P product in a dose-ranging, placebo-controlled study [abstract no. W437]. Nephrol Dial Transplant 2003; 18 Suppl. 4: 686. Plus poster presented at the 40th ERA-EDTA World Congress of Nephrology; 2003 Jun 8–12; Berlin

    Google Scholar 

  25. Hutchison AJ. The novel, non-aluminium, non-calcium phosphate binder, lanthanum carbonate (Fosrenol™), is an effective treatment for hyperphosphataemia and has a good safety profile [abstract no. SA-P0599]. J Am Soc Nephrol 2002 Nov 1; 13 Suppl.: 385A–6A. Plus poster presented at the 35th Annual Meeting and Scientific Exposition of the American Society of Nephrology; 2002 Nov 1–4; Philadelphia

    Google Scholar 

  26. Finn WF, Joy MS, Webster I. Lanthanum carbonate vs. standard therapy in hyperphosphatemia: interim findings from a 2-year safety and outcomes study [abstract no. SU-PO1040]. J Am Soc Nephrol 2003 Nov; 14 Suppl.: 764A. Plus poster presented at the 36th Annual Meeting and Scientific Exposition of the American Society of Nephrology; 2003 Nov 14–17; San Diego

    Google Scholar 

  27. Joy MS, Finn WF, LAM-302 Study Group. Randomized, double-blind, placebo-controlled, dose-titration, phase III study assessing the efficacy and tolerability of lanthanum carbonate: a new phosphate binder for the treatment of hyperphosphatemia. Am J Kidney Dis 2003 Jul; 42(1): 96–107

    Article  PubMed  CAS  Google Scholar 

  28. Hutchison A, Webster I. Maintained safety, tolerability and efficacy of lanthanum carbonate (Fosrenol®) during long-term therapy in hemodialysis patients [abstract no. SU-PO1039]. J Am Soc Nephrol 2003 Nov; 14 Suppl.: 764A. Plus poster presented at the 36th Annual Meeting and Scientific Exposition of the American Society of Nephrology; 2003 Nov 14–17; San Diego

    Google Scholar 

  29. D’Haese PC, Spasovski GB, Sikole A, et al. A multicenter study on the effects of lanthanum carbonate (Fosrenol™) and calcium carbonate on renal bone disease in dialysis patients. Kidney Int 2003 Jun; 63 Suppl. 85: S73–8

    Article  Google Scholar 

  30. Damment S, Pennick M, Gill M. The pharmacokinetics of a new non-aluminium, non-calcium phosphate binder, lanthanum carbonate (Fosrenol®) [abstract no. 141]. Am J Nephrol 2004; 24(1): 106

    Google Scholar 

  31. Sacchiero R, Berlove D, Brezzani A, et al. Lanthanum deposition in tissues of renal compromised rats fed lanthanum carbonate for 28 days [abstract no. F-PO658]. J Am Soc Nephrol 2003 Nov; 14 Suppl.: 205A

    Article  Google Scholar 

  32. Yang W-C, Chiang S-S, Chen J-B. Efficacy and safety of lanthanum carbonate in the treatment of hyperphosphatemia in Chinese chronic renal failure patients [abstract no. F-PO652]. J Am Soc Nephrol 2003 Nov; 14 Suppl.: 204A. Plus poster presented at the 36th Annual Meeting and Scientific Exposition of the American Society of Nephrology; 2003 Nov 14–17; San Diego

    Google Scholar 

  33. Joy MS, Fiddler G, Finn WF, et al. Long-term safety, tolerability and efficacy of lanthanum carbonate in haemodialysis patients: an extension study to a phase II trial [abstract no. W435]. Nephrol Dial Transplant 2003; 18 Suppl.: 685. Plus poster presented at the 40th ERA-EDTA World Congress of Nephrology; 2003 Jun 8–12; Berlin

    Google Scholar 

  34. Hutchison A, Webster I, Gill M, et al. Safety and tolerability of lanthanum carbonate in haemodialysis patients: a 12-month study [abstract no. W432]. Nephrol Dial Transplant 2003; 18 Suppl.: 684. Plus poster presented at the 40th ERA-EDTA World Congress of Nephrology; 2003 Jun 8–12; Berlin

    Google Scholar 

  35. Finn WF, Joy MS, Webster I, et al. Long-term treatment with lanthanum carbonate (Fosrenol™) is safe and effective in haemodialysis patients [abstract no. W434]. Nephrol Dial Transplant 2003; 18 Suppl.: 685. Plus poster presented at the 40th ERA-EDTA World Congress of Nephrology; 2003 Jun 8–12; Berlin

    Google Scholar 

  36. Hutchison A, Al-Baaj F, Webster I, et al. Lanthanum carbonate versus calcium carbonate: effect on parathyroid hormone levels [abstract no. 177]. Am J Nephrol 2004; 24(1): 119–20

    Google Scholar 

  37. Torres A, De Broe ME, D’Haese PC, et al. A 1-year study comparing the safety and efficacy of lanthanum carbonate (Fosrenol®) and calcium carbonate in dialysis patients [abstract no. 138]. Am J Nephrol 2004; 24(1): 105

    Google Scholar 

  38. Shire Pharmaceuticals Group plc. First global approval for Fosrenol® (lanthanum carbonate) [media release]. 2004 March 24

  39. Shire Pharmaceuticals Group plc. Shire receives approvable letter from FDA for Fosrenol®; positive step for treatment related to kidney disease in the United States [online]. Available from URL: http://www.shire.com [Accessed 2003 Jul 18]

Download references

Author information

Authors and Affiliations

  1. Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland, 1311, New Zealand

    Tracy Swainston Harrison & Lesley J. Scott

Authors
  1. Tracy Swainston Harrison
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lesley J. Scott
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tracy Swainston Harrison.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harrison, T.S., Scott, L.J. Lanthanum Carbonate. Drugs 64, 985–996 (2004). https://doi.org/10.2165/00003495-200464090-00008

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-200464090-00008

Keywords

Search

Navigation