Summary

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• Sodium zirconium cyclosilicate (Lokelma) is indicated for the treatment of hyperkalemia in adults, effectively reducing serum potassium levels with a significant proportion of individuals achieving normal potassium levels across several studies.
• Nine systematic reviews and meta-analyses were reviewed to gather information about Lokelma's effectiveness and safety profile.
• Comparisons suggest that Lokelma is as effective as other novel potassium binders like patiromer in managing hyperkalemia, especially among patients with heart failure or chronic kidney disease who are using renin-angiotensin-aldosterone system inhibitors or mineralocorticoid receptor antagonists.
• The safety profile of Lokelma was generally acceptable according to the reviewed studies, but an increase in the incidence of hypokalemia was noted as a side effect requiring careful monitoring.
• Compared to traditional potassium exchange resins like sodium polystyrene sulfonate, fewer gastrointestinal side effects have been associated with Lokelma, making it a preferential option for long-term management of hyperkalemia in patients with chronic kidney disease. However, one study mentioned an increased risk of edema compared to placebo, which should be considered particularly for patients with heart failure or chronic kidney disease due to their fluid management needs.
• The effectiveness and safety profiles make this drug beneficial not only for the general population but also for specific patient subgroups such as those suffering from heart failure and chronic kidney disease, along with high-risk populations including those with diabetes or using renin-angiotensin-aldosterone system inhibitors.