USE OF FERRIC CITRATE IN THE TREATMENT OF AND THE REDUCTION OF MORTALITY AND MORBIDITY RELATED TO ADVERSE CARDIAC EVENTS IN CHRONIC KIDNEY DISEASE PATIENTS
Methods of administering ferric citrate to reduce and/or control serum phosphorus levels, increase serum bicarbonate levels, improve one or more iron storage parameters (e.g., increase serum ferritin levels, increase transferrin saturation (TSAT), increase hemoglobin concentration), increase iron absorption, maintain iron stores, treat iron deficiency, treat anemia, reduce the need for IV iron, reduce the need for erythropoiesis-stimulating agents (ESAs), and/or reduce mortality and morbidity related to adverse cardiac events in chronic kidney disease patients, are disclosed.
1 . A method of reducing mortality and morbidity related to adverse cardiac events in a human patient with chronic kidney disease, comprising orally administering ferric citrate to a chronic kidney disease patient in an amount ranging from 1 g to 18 g.
2 . (canceled)
3 . The method of claim 1 , wherein the chronic kidney disease patient is a non-dialysis chronic kidney disease patient.
4 . The method of claim 1 , wherein the ferric citrate is administered in a tablet dosage form.
5 . The method of claim 4 , wherein the tablet dosage form comprises 1 gram of the ferric citrate.
6 . The method of claim 1 , wherein the adverse cardiac event is selected from the group consisting of: heart failure, ventricular arrhythmias, myocardial infarction, decreased left ventricular (LV) ejection fraction, sudden cardiac death, aortic root dilation, and a cerebrovascular event.
7 . The method of claim 1 , wherein the ferric citrate raises the hemoglobin level of the patient to a level above 10 g/dL.
8 . The method of claim 1 , wherein the ferric citrate reduces FGF-23 levels of the patient by at least 30% compared to baseline.
9 . (canceled)
10 . A method of reducing incidence or risk of hospitalizations related to adverse cardiac events in a human patient with chronic kidney disease, comprising orally administering ferric citrate to a chronic kidney disease patient in an amount ranging from 1 g to 18 g.
11 . (canceled)
12 . A method of treating left ventricular hypertrophy (LVH) in a human patient with chronic kidney disease, comprising orally administering ferric citrate to a chronic kidney disease patient in an amount ranging from 1 g to 18 g.
13 . The method of claim 1 , wherein the administration of the ferric citrate reduces the patient's FGF-23 levels.
14 . The method of claim 13 , wherein the FGF-23 levels measured are intact FGF-23 and C-terminal FGF-23 fragments.
15 . The method of claim 1 , wherein the patient has elevated FGF-23 levels prior to the administration of the ferric citrate.
16 . The method of claim 10 , wherein the ferric citrate is administered in a tablet dosage form.
17 . The method of claim 4 , wherein each tablet comprises approximately 65% to approximately 92% by weight of ferric citrate, approximately 4.5% to approximately 30% by weight of a binder, and approximately 0.5% to approximately 3% by weight of a lubricant; and wherein at least 80% of the ferric citrate in the tablet is dissolved in less than or equal to 60 minutes as measured by test method USP <711>, and the water content of the tablet is less than 11% by loss on drying (LOD).
18 . The method of claim 16 , wherein each tablet comprises approximately 65% to approximately 92% by weight of ferric citrate, approximately 4.5% to approximately 30% by weight of a binder, and approximately 0.5% to approximately 3% by weight of a lubricant; and wherein at least 80% of the ferric citrate in the tablet is dissolved in less than or equal to 60 minutes as measured by test method USP <711>, and the water content of the tablet is less than 11% by loss on drying (LOD).
19 . The method of claim 17 , wherein the binder is pregelatinized starch and the lubricant is calcium stearate.
20 . The method of claim 18 , wherein the binder is pregelatinized starch and the lubricant is calcium stearate.
21 . The method of claim 10 , wherein the chronic kidney disease patient is a non-dialysis chronic kidney disease patient.
22 . The method of claim 10 , wherein the administration of the ferric citrate reduces the patient's FGF-23 levels.
23 . The method of claim 10 , wherein the ferric citrate reduces FGF-23 levels of the patient by at least 30% compared to baseline.
24 . The method of claim 22 , wherein the FGF-23 levels measured are intact FGF-23 and C-terminal FGF-23 fragments.
25 . The method of claim 10 , wherein the patient has elevated FGF-23 levels prior to the administration of the ferric citrate.
26 . The method of claim 12 , wherein the administration of the ferric citrate reduces the patient's FGF-23 levels.
27 . The method of claim 12 , wherein the patient has FGF-23 levels that are elevated relative to the normal range in healthy humans.
28 . The method of claim 1 , wherein the ferric citrate is a complex comprising iron(III) and citric acid with a molar ratio of 1:0.69 to 1:0.87.
29 . The method of claim 1 , wherein the ferric citrate is iron (+3), x (1, 2, 3-propanetricarboxylic acid, 2-hydroxy-), y (H 2 O)
x=0.70-0.87, y=1.9-3.3.
30 . The method of claim 10 , wherein the ferric citrate is a complex comprising iron(III) and citric acid with a molar ratio of 1:0.69 to 1:0.87.
31 . The method of claim 10 , wherein the ferric citrate is iron (+3), x (1, 2, 3-propanetricarboxylic acid, 2-hydroxy-), y (H 2 O)
x=0.70-0.87, y=1.9-3.3.