Summary

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• Patiromer (Veltassa) is indicated for the treatment of hyperkalemia in adults and pediatric patients aged 12 years and older.
• A total of 13 studies from systematic reviews/meta-analyses were reviewed to gather information about patiromer.
• Patiromer has been shown to effectively manage hyperkalemia, particularly improving the optimization of mineralocorticoid receptor antagonists (MRAs), which is crucial for heart failure patients, significantly reducing hyperkalemic episodes compared to placebo.
• In heart failure patients, patiromer reduces the incidence of hyperkalemia and optimizes RAASi therapy, while decreasing discontinuation due to hyperkalemia; however, it carries an increased risk of hypokalemia.
• Compared with other potassium binders like sodium zirconium cyclosilicate (SZC), both are effective in reducing serum potassium levels but have different adverse effects: patiromer's gastrointestinal issues versus SZC's association with edema.
• Long-term studies indicate that both SZC and patiromer maintain normokalemia effectively; however, SZC may have a slight edge for long-term management due to its sodium absorption capabilities.
• Across different stages of chronic kidney disease (CKD), patiromer significantly reduced serum potassium levels with fewer gastrointestinal adverse effects compared to older polystyrene sulfonates.