A Targeted Release Capsule of Lanthanum Carbonate: a New Efficient Cheap Treatment for Primary Hyperoxalurias
Introduction: Primary hyperoxaluria (PH) is a devastating disease in children and adults. Recently, a substantial progress in the treatment of this deadly disease has been made that consists of the introduction of the RNA inhibitors, lumasiran and nedosiran, which deplete the substrate for oxalate s...
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Elsevier
2025-02-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024924020424 |
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| author | Marc E. De Broe Marc P. Uytterhoeven Jan De Causmaecker Yannick De Brucker Erik D. Snelders Johan Van De Walle Koen Van Hoeck Dominique Trouet Monique Elseviers |
| author_facet | Marc E. De Broe Marc P. Uytterhoeven Jan De Causmaecker Yannick De Brucker Erik D. Snelders Johan Van De Walle Koen Van Hoeck Dominique Trouet Monique Elseviers |
| author_sort | Marc E. De Broe |
| collection | DOAJ |
| description | Introduction: Primary hyperoxaluria (PH) is a devastating disease in children and adults. Recently, a substantial progress in the treatment of this deadly disease has been made that consists of the introduction of the RNA inhibitors, lumasiran and nedosiran, which deplete the substrate for oxalate synthesis. Methods: Lanthanum carbonate (Lanth.Carb., La2[CO3]3) is a powerful phosphate binder having a strong affinity to oxalate. Its use as such in PH is not relevant because patients with normal renal function develop a severe phosphate depletion without a clear effect on oxalate balance. Considering that the absorption of phosphate is in the early gastrointestinal (GI) tract and mainly in the distal part of the GI tract for oxalate, we developed a targeted release capsule (trc) containing 500 mg Lant.Carb. released in the distal part of the GI tract as proven by radiological investigations of the radiopaque trcLanth.Carb. Results: Four patients with PH and estimated glomerular filtration rate > 60 ml/min per 1.73 m2 were treated with trcLanth.Carb., which turned out to decrease the urinary oxalate concentrations clearly < 0.51 mmol/24 h per 1.73 m2,45 mg/24 h per 1.73 m2 (considered as upper limit of normal), after 2.5 months of treatment in 3 patients and 18 months in 1 patient. Calciuria remained normal or decreased slightly. Phosphaturia and phosphatemia remained normal and stable in all 4 cases. Conclusion: trcLanth.Carb. is a promising repurposed, efficient, nontoxic, and cheap drug, lacking serious side effects in the treatment of any type of PH in whatever place in the world. A randomized controlled trial supporting this proof-of-concept is the next step. |
| format | Article |
| id | doaj-art-49ac99501ca24a84b2b74dd72ee6cb05 |
| institution | OA Journals |
| issn | 2468-0249 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-49ac99501ca24a84b2b74dd72ee6cb052025-08-20T02:06:00ZengElsevierKidney International Reports2468-02492025-02-0110250351510.1016/j.ekir.2024.11.020A Targeted Release Capsule of Lanthanum Carbonate: a New Efficient Cheap Treatment for Primary HyperoxaluriasMarc E. De Broe0Marc P. Uytterhoeven1Jan De Causmaecker2Yannick De Brucker3Erik D. Snelders4Johan Van De Walle5Koen Van Hoeck6Dominique Trouet7Monique Elseviers8Laboratory of Pathophysiology, University of Antwerp, Wilrijk, Belgium; Correspondence: Marc E. De Broe, Hillare 12, B-9160 Lokeren, Belgium.Sonic Healthcare Benelux AML, Antwerp, BelgiumPharmacist, Lokeren, BelgiumDepartment of Radiology, Vrije Universiteit Brussels, Ixelles, BelgiumDepartment of Nephrology, Antwerp University Hospital, Edegem, Belgium; Laboratory of Experimental Medicine and Pediatrics (LEMP), University of Antwerp, Wilrijk, BelgiumDepartment Pediatric Nephrology, Ghent University Hospital, Ghent, BelgiumLaboratory of Experimental Medicine and Pediatrics (LEMP), University of Antwerp, Wilrijk, Belgium; Department Pediatric Nephrology, Antwerp University Hospital, Edegem, BelgiumLaboratory of Experimental Medicine and Pediatrics (LEMP), University of Antwerp, Wilrijk, Belgium; Department Pediatric Nephrology, Antwerp University Hospital, Edegem, BelgiumCenter for Research and Innovation in Care, University of Antwerp, Antwerp, BelgiumIntroduction: Primary hyperoxaluria (PH) is a devastating disease in children and adults. Recently, a substantial progress in the treatment of this deadly disease has been made that consists of the introduction of the RNA inhibitors, lumasiran and nedosiran, which deplete the substrate for oxalate synthesis. Methods: Lanthanum carbonate (Lanth.Carb., La2[CO3]3) is a powerful phosphate binder having a strong affinity to oxalate. Its use as such in PH is not relevant because patients with normal renal function develop a severe phosphate depletion without a clear effect on oxalate balance. Considering that the absorption of phosphate is in the early gastrointestinal (GI) tract and mainly in the distal part of the GI tract for oxalate, we developed a targeted release capsule (trc) containing 500 mg Lant.Carb. released in the distal part of the GI tract as proven by radiological investigations of the radiopaque trcLanth.Carb. Results: Four patients with PH and estimated glomerular filtration rate > 60 ml/min per 1.73 m2 were treated with trcLanth.Carb., which turned out to decrease the urinary oxalate concentrations clearly < 0.51 mmol/24 h per 1.73 m2,45 mg/24 h per 1.73 m2 (considered as upper limit of normal), after 2.5 months of treatment in 3 patients and 18 months in 1 patient. Calciuria remained normal or decreased slightly. Phosphaturia and phosphatemia remained normal and stable in all 4 cases. Conclusion: trcLanth.Carb. is a promising repurposed, efficient, nontoxic, and cheap drug, lacking serious side effects in the treatment of any type of PH in whatever place in the world. A randomized controlled trial supporting this proof-of-concept is the next step.http://www.sciencedirect.com/science/article/pii/S2468024924020424primary hyperoxaluriasefficientcheaptreatmenttrc-Lanthanum Carbonate |
| spellingShingle | Marc E. De Broe Marc P. Uytterhoeven Jan De Causmaecker Yannick De Brucker Erik D. Snelders Johan Van De Walle Koen Van Hoeck Dominique Trouet Monique Elseviers A Targeted Release Capsule of Lanthanum Carbonate: a New Efficient Cheap Treatment for Primary Hyperoxalurias Kidney International Reports primary hyperoxalurias efficient cheap treatment trc-Lanthanum Carbonate |
| title | A Targeted Release Capsule of Lanthanum Carbonate: a New Efficient Cheap Treatment for Primary Hyperoxalurias |
| title_full | A Targeted Release Capsule of Lanthanum Carbonate: a New Efficient Cheap Treatment for Primary Hyperoxalurias |
| title_fullStr | A Targeted Release Capsule of Lanthanum Carbonate: a New Efficient Cheap Treatment for Primary Hyperoxalurias |
| title_full_unstemmed | A Targeted Release Capsule of Lanthanum Carbonate: a New Efficient Cheap Treatment for Primary Hyperoxalurias |
| title_short | A Targeted Release Capsule of Lanthanum Carbonate: a New Efficient Cheap Treatment for Primary Hyperoxalurias |
| title_sort | targeted release capsule of lanthanum carbonate a new efficient cheap treatment for primary hyperoxalurias |
| topic | primary hyperoxalurias efficient cheap treatment trc-Lanthanum Carbonate |
| url | http://www.sciencedirect.com/science/article/pii/S2468024924020424 |
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