Lanthanum Carbonate

Abstract

To review the pharmacology, pharmacokinetics, clinical efficacy, and safety profile of lanthanum carbonate, a phosphate binder for chronic kidney disease (CKD). Information was selected from PubMed (1965-October 2005). All studies presented as scientific posters and abstracts from nephrology meetings from 1999 to 2005 were also included. All published articles regarding lanthanum carbonate were included. In addition, abstracts and presentations from scientific meeting symposia were also considered for inclusion. Lanthanum carbonate has been recently approved as non-calcium-based therapy for phosphate reduction in patients with stage 5 CKD requiring dialysis. The recommended dose is 250-500 mg with meals, for a maximum of 1500 mg daily. Clinical studies have shown short- and long-term safety with lanthanum carbonate administration. Adverse effects were primarily gastrointestinal in nature. Clinical trials have also shown reductions in serum phosphorus to target concentrations, reductions in associated calcium-phosphorus product, and minimal effects on serum calcium and parathyroid hormone concentrations. Lanthanum carbonate is an effective phosphate-binding agent without significant risk of hypercalcemia or worsening metabolic acidosis. Lanthanum carbonate is a safe and effective drug for reduction of elevated serum phosphorus levels associated with stage 5 CKD. The role of lanthanum carbonate relative to other phosphate-binding drugs, such as calcium salts and sevelamer, remains to be determined.