ArticleAdvances in therapy2026
Real-World Evidence for Sevelamer vs Calcium-Containing Phosphate Binders in Long-Term Effectiveness and Safety Among Patients with Non-Dialysis CKD: The REVEAL Study.
Article in Advances in therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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10 authors.
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Abstract
introductionElevated serum phosphate is a major risk factor for cardiovascular events and mortality in patients with chronic kidney disease (CKD). Both calcium- and non-calcium-containing phosphate binders (CPBs and NCPBs) are effective at lowering serum phosphate in patients with non-dialysis-dependent CKD (ND-CKD). The critical knowledge gap is whether CPBs or NCPBs provide meaningful long-term benefits for patients with ND-CKD, including slowing progression to end-stage renal disease (ESRD) and reducing cardiovascular events.
methodsThis retrospective study was based on the Optum Clinformatics
resultsOf 9047 patients who underwent PSM (sevelamer, n = 6644; CPBs, n = 2403), data from 4798 were analysed (2399 in each group). Over 3 years, RRT initiation had significantly lower incidence with sevelamer than CPBs (65.0% vs 70.3%; hazard ratio [HR] 0.84, 95% confidence interval [CI] 0.79-0.91, P < 0.0001). MACE (44.9% vs 50.7%; HR 0.91, 95% CI 0.84-0.99, P = 0.0249) and MACE plus (51.9% vs 59.1%; HR 0.88, 95% CI 0.81-0.95, P = 0.0009) also had significantly lower incidence with sevelamer than CPBs. RRT initiation had significantly lower incidence with sevelamer versus CPB in subgroup analyses by age, sex, race, disease stage and medical history.
conclusionIn this real-world long-term study, sevelamer was associated with beneficial outcomes over CPBs for hyperphosphataemia treatment in patients with ND-CKD. Further definitive studies are needed to confirm this finding.
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