Exploring Emerging Treatments for Hyperkalemia

Potassium Physiology

Definitions of Hyperkalemia Vary

Major Causes of Hyperkalemia

Prevalence of Hyperkalemia

Increasing Incidence of Hyperkalemia

Relationship Between Potassium Level and Patient Outcome

Benefit/Risk of RAAS Inhibitors

What We Know About RAAS Inhibitor Therapy in HF rEF, pEF, and Post-MI

Guidelines Recommendation for Stage C HFrEF

ATLAS Effects of Low- vs High-Dose Lisinopril on Morbidity and Morality in Chronic HF

HEAAL Study Clinical Outcomes of High- vs Low-Dose Losartan in Patients With HF

RAAS Inhibitor Doses and Mortality

Spironolactone Causes Hyperkalemia in a Dose-Dependent Fashion

Renal Function, Spironolactone, and Hyperkalemia in HF

Hyperkalemia Continues to Be an Issue in HF PARADIGM-HF

Spironolactone Prescriptions and Hospital Admissions for Hyperkalemia Increased After RALES

ACCF/AHA Guidance on Serum Potassium Monitoring in Patients With HF Who Are Taking a RAAS Inhibitor

Frequency of Potassium Monitoring After Initiation of MRAs in Patients With HF

Higher Incidence of Hyperkalemia With MRAs in the Real World

Real-World RAAS Inhibitor Use

Nearly Half of Patients on Maximum Dose of RAAS Inhibitor Had Down-Titrated or Discontinued RAAS Inhibitor Therapy After a Hyperkalemia Event

MRA-Eligible Patients With HF Are Undertreated Get With the Guidelines-HF Registry

Challenge of Balancing RAAS Inhibitor Use and Potassium Level

Challenges of Hyperkalemia in At-Risk Patients

Treatment Options for Hyperkalemia No Effective Long-Term Option

Chronic Management of Hyperkalemia Before Era of New Potassium Binders

SPS

SPS With Sorbitol May Be Associated With Colonic Necrosis

Patiromer Structure

Main Studies Evaluating the Efficacy and Safety of Patiromer

OPAL-HK Phase 3 Study in Patients With CKD on RAAS Inhibitor With Hyperkalemia

OPAL-HK, Phase 3 Part A Met Primary and Secondary Efficacy Endpoints -- Statistically Significant Results

OPAL-HK Phase 3, Part B Exploratory Endpoints -- Statistically Significant Results

OPAL-HK, Phase 3 Part A and B AE Profile

Serum Potassium Levels Over 52 Weeks and During Post-Treatment Follow-Up

PEARL-HF Study Design

PEARL-HF Study With Patiromer

PEARL-HF Proportion of Subjects Able to Increase Spironolactone Dose to 50 mg/day

ZS-9 Structure

ZS-9 Clinical Development Programme

ZS-9 HARMONIZE

ZS003 and HARMONIZE Pooled Analyses Patients With Potassium Level > 6 mEq/L

Phase 3 HARMONIZE Study (ZS-004)

Long-Term Safety and Efficacy Study of ZS-9 (ZS-005)

Take-Home Messages

Abbreviations

Abbreviations (cont)