Patiromer oral suspension is a high capacity, non-absorbed polymer-based potassium binder being developed for the treatment of hyperkalaemia. A New Drug Application was filed in October 2014 with the US FDA; an application has not yet been filed in the EU.
As noted in an accompanying editorial, the maximum duration of treatment with patiromer in this study was 12 weeks; it is unclear if constipation (and other side-effects) would be more troublesome with longer-term treatment. Caution is therefore required as many patients are likely to take it for much longer periods of time. As the decrease in potassium associated with this treatment appears to be gradual, it is unclear how well it would perform if used in acute treatment (it excluded patients with potassium levels >6.5 mmol/L, ECG changes, hospitalised patients and those undergoing dialysis). Further study is required to determine whether the co-administration of patiromer would permit long-term administration of RAAS blockers in this setting.