Sodium polystyrene sulfonate linked to higher risk of hospitalization for adverse GI events

Reference

Noel JA, Bota SE, Petrcich W, et al. Risk of hospitalization for serious adverse gastrointestinal events associated with sodium polystyrene sulfonate use in patients of advanced age. JAMA Intern Med 2019 June 10. [Epub ahead of print]

Synopsis

Sodium polystyrene sulfonate is used for the treatment of hyperkalemia and has been linked to GI injuries in case reports and small trials. In this large population-based Canadian study, investigators used government databases to match 20,002 patients older than 65 years who received a first prescription for sodium polystyrene sulfonate with the same number of patients who had never received a prescription. The matched groups were similar at baseline: median age was 78 years, more than half had a history of hypertension and diabetes, and most patients were taking medications that can cause hyperkalemia. The primary outcome was hospitalization or an emergency department visit for an adverse GI event, such as intestinal ischemia/thrombosis, ulceration/perforation, or resection/ostomy, within 30 days of receipt of the prescription. Although these events were infrequent, exposure to sodium polystyrene sulfonate was associated with a higher risk of hospitalization for serious GI events (0.2% in the exposed group vs 0.1% in the unexposed group; hazard ratio [HR] 1.94; 95% CI 1.10 - 3.41). The risk was highest for intestinal ischemia or thrombosis (HR 4.92;1.09 - 22.25).