So in the middle of the potassium tweet fest this tweet caught my attention:
Just what we need, a modern trial that confirms or refutes this data showing the futility of Kayexalate:
That figure is from this 1998 Study by the great Michael Emmett. A modern study could confirm or refute the concerns about the safety signal regarding kayexalate:
From Gastrointestinal Adverse Events with Sodium Polystyrene Sulfonate (Kayexalate) Use: A Systematic Review The American Journal of Medicine Vol 126, Issue 3, Pages 264.e9–264.e24, March 2013.
So I was a little disappointed to see that the study had been halted
Then came the part that was too juicy for me to resist:
It was stopped due to a safety signal! I immediately thought it must be the previously known GI problems. Kayexalate was so dangerous that modern researchers couldn't even study the thing! I tweeted a little victory lap:
This has been retweeted 16 times at this moment. It is the tweet that has received the most engagement of any done by NephJC in the last week. It was the number 1 tweet!
But I think it is a bit misleading for a number of reasons:
- the study was being done by ZS Pharma the manufacturer of ZS9, not exactly an unbiased observer
- there were only two adverse reactions and they don't seem related to the study drug, they were A-fib and long QT
Seems a little fishy. The cynic could imagine that the early data showed ZS-9 to be no better than Kayexalate so the company started looking for a reason to cancel the project. They saw the unbalanced adverse events, 2 with SPS versus 0 with ZS-9 and spiked the study. Luckily, I'm not cynical.
I posted a retraction with the new data:
Predictably the retraction has not gotten the same social media traction