Is combined calcium/magnesium phosphate binder really noninferior to sevelamer hydrochloride?

摘要

In a recent randomized controlled trial by De Francisco et al. [1], combined calcium acetate/magnesium carbonate (CaMg) phosphate binder was shown to be noninferior to the comparator (sevelamer hydrochloride) at controlling serum phosphorus levels at Week 25. Given that an efficient and relatively affordable drug would certainly be of great benefit to the majority of chronic kidney disease (CKD) patients, this report opens new horizons in this field. Nevertheless, a few issues with regard to the confirmation 'noninferiority' in this study should be discussed.