sodium zirconium cyclosilicate (Lokelma)

following a resubmission:

sodium zirconium cyclosilicate (Lokelma®) is accepted for restricted use within NHSScotland.

Indication under review: treatment of hyperkalaemia in adult patients.

SMC restriction: patients with hyperkalaemia (defined as a serum potassium of >6.0mmol/L) with chronic kidney disease (CKD) stage 3b to 5 and/or heart failure, who would otherwise need to down-titrate or discontinue their renin-angiotensin-aldosterone system inhibitor (RAASi) therapy to maintain a clinically acceptable serum potassium level (normokalaemia)

Sodium zirconium cyclosilicate, compared with placebo, reduced serum potassium in two and four-week studies in adults with hyperkalaemia. In an uncontrolled one-year study sodium zirconium cyclosilicate produced normal serum potassium in a proportion of adults with hyperkalaemia.

This advice applies only in the context of an approved NHSScotland Patient Access Scheme (PAS) delivering the cost-effectiveness results upon which the decision was based, or a PAS/list price that is equivalent or lower.