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SMC expands guidance for Lokelma to emergency care settings

New access to treatment involves adult patients with hyperkalaemia across Scotland.

AstraZeneca has announced that the Scottish Medicines Consortium (SMC) has updated advice for Lokelma for adult patients with hyperkalaemia in Scotland.

The advice to the SMC now means patients can access Lokelma – also known as sodium zirconium cyclosilicate (SZC) – in emergency care settings for the treatment of acute, life-threatening hyperkalaemia alongside standard of care.

Consequently, SZC is accepted for restricted use within NHS Scotland within outpatient care for hyperkalaemia patients with chronic kidney disease or heart failure, who would otherwise need to down-titrate or discontinue their renin-angiotensin-aldosterone system therapy.

The updated SMC advice addresses a particular need in Scotland for access to potassium-binding treatments that removes potassium from the blood. Meanwhile, the National Institute for Health and Care Excellence (NICE) for England, Wales and Northern Ireland issued a positive recommendation for SZC in the emergency care setting and therefore, this updated SMC advice also addresses potential equality of care issues in enabling access for Scottish patients.

“For adult patients in Scotland who develop high potassium levels, today’s announcement will be an extremely welcome milestone,” Dr Iain Macintyre, consultant nephrologist and clinical pharmacologist at the New Royal Infirmary of Edinburgh NHS Lothian, explained.

He added: “Risk of developing hyperkalaemia is increased for patients taking life-saving cardio-renal medications and the decision today from the Scottish Medicines Consortium means that patients with this condition will now have access to an important treatment option in the emergency care setting when the condition is potentially life-threatening.”

Hyperkalaemia is a medical condition of elevated potassium levels in the blood, and in severe cases, it may lead to cardiac arrest and death. Furthermore, there is an increased risk of developing hyperkalaemia in patients with chronic kidney disease and heart failure compared to the general population.