AK.....RLYP has already discussed with the FDA providing follow-up studies in various areas affecting the new drug approval. One that immediately comes to mind is drug interaction. There ihas been no evidence of drug interaction with Patriomer but they have voluntarily agreed to monitor usage on that issue and provide updated information to the FDA. ZSPH If they get to approval in May will probably. have to do the same things with further monitoring in potential fluid overload and fluid retention and edema. All part of any new drug coming out on the market.
Thinking of perscribing ZS-9 to my patients but need your clarification My broker sent me the Citi report
on ZSPH and ZS-9. 1mmol is about 23mg. Citi's report has a section where they calculate 30 mmol NA+
Exchanged for K+.in ZS-9. Seems like a lot of NA to me but what do you think? TIA Dr.Golong
If ZS-9 was available, and was actually shown to reduce K levels to normal in 2-4 hours, and was not a figment of illusory bodily reactions like fasting or sodium phosphate, I would consider giving it to him.on
Sunday. More than likely though give him insulin in the hospital again Monday morning prior to surgery.
The mention of sodium bicarbonate as a by product of the ZS-9 exchange of K was mentioned in a recent
article that I sent to you as a possible reason for the "fast acting" alleged properties of ZS-9, as was natural insulin reaction of fasting trial participants. Only further trials can verify that K is actually being removed rapidly from the patient's system in the first 2 hours as claimed by ZSPH, or are the results merely indicative
of the two reactions described above. As you say, the long term trial results will speak for themselves one way or the other. Can't wait frankly!
Sodium exchanged for K in even one recommended treatment of ZS-9 is something like drinking six mini cans of Dr Pepper. Read the C report. If the treated group with CHF do not have fluid overload or edema
after using ZS9 for a full year I'll be very surprised frankly.
Yes...the stock is acting terribly for sure but just have to ignore the noise and go with what you believe to be true and that is approval,,,,with broad labeling.....and no required follow up studies.... Hope to he_l I'm right.
So in both cases no need to, nor probably recommended, to have patients who have had IV insulin to start taking ZS-9 and/or Patiromer, until at least 24 hours after being discharged, and more than likely 48 hours if they were given the "ultra long" formula... Faster acting is irrelevant at that stage...
Analog "long" insulin remains in your system up to 24 hours...and acts within an hour.
Analog "ultra long" insulin reains in your system in excess of 42 hours and acts within an hour.
AK....Not sure you're understanding what I'm trying to tell you either...
A patient comes in with an immediate "emergency" need to reduce his K levels from 6.0 to normal, and fast!
They use insulin, not ZS-9 or Patiromer. After an 45 minutes his K levels are back to say 5.1. At that point insulin does not "wear" off in 30 minutes, but stays in his system for some time. K levels do not immediately shoot up from 5.1 to 6.0 the very next day. That situation will literally take days, if not weeks. In the interim he would ultimately be released with instructioins to use either Patiromer or ZS-9 on a daily basis to keep his K levels "normal". There is no benefit in ZS-9 acting faster then Patiromer as both will normalize K levels within 48 hours.
I don't think so AK.... ZS-9 starts to work in about 2 hrs...Normalizes I think in abt 4-8hrs. So the ER is not likely to send the patient home unless K was totally within normal ranges, and I doubt they're going to use up
an ER room while the patient lies on a gurney to observe him for 4-8 hours. So it's basically impractical.
Keep your fingers crossed on 10/21 ~!!!
AK...Long time no hear from yah! Serious opinions?...Uh...how about the stock was accumulated for weeks from $48-$58 for "reasons unknown" then those same folks likely sold on the announcement day of discussions between the two companies , and the only ones left have been the retail know nothing longs
too greedy to sell when it was $84 hoping for a $100 buyout....lol...Present company excluded AK!
$72 to $65 thus far today in an up market? Not looking too good right now for the ZSPH buyout hopefuls.
Of course the smart ones who were accumulating the stock from $48-$58 likely sold on the announcement day of discussions between the two companies, and are long gone. They just got lucky I guess... lol!
ZSPH.... I thought that was a phony buyout hype thing from day one. All the alleged acquiring company said was they were talking with ZSPH about possible business combinations. That could mean anything. No news since that day. Looks like whatever it was has fallen apart.
Those who sold in the 80's on the day one run up were the winners. Of course they knew what was coming from day one if you look at the accumulation pattern on the stock from $48 to $58. SEC should really look at that one.
Bout time.... Looks like the Street is now accumulating the stock bigtime for the Oct 21st PDUFA date.
Good sign and welcome accumulation. This is just the start IMHO. GLTALs
Thanks Freddy for the TGTX mention....Keep that post and you can thank me later. I see you just got into that name as well! GL....
Silver..... Nice hearing from you again. Reading this Board but not posting. Been out of the stock since $38.50 so nothing to add and not trying to add salt to anybody's wound (position).
I will respond to Dilivent though. No, not reading Hillary's mind but just acknowledging the risk/reward in holding any bio with large gains going into a pivotal Phase 3 trial regardless of the odds of success. Each to their own.
TTPH.... In from $8.38 avg and the stock is $7.51 as of yesterday's close. Probably should have sold on the bounce to $12 and bought back in lower but that would have been clairvoyant. Never profess to have that skill, only common sense and logic sometimes...
DRTX.....Bought in the 7's....Sold when it hit $16, then bought back half the position I sold when it dipped quickly back into the 12's just days before the buyout at $23.50. That one was pure luck.
If I had known what I was doing I would have bought the entire position back. But when you sell
at $16 and the stock is $12 in a fairly short time after that it wasn't hard to figure that maybe you should buy some of what you sold back. Genius? No just common sense,.luck and logic.
And you forgot to mention TRSX which you may have missed. In from the 7's and held for the buyout at $16. Hope you had that one as well.
GL to you and all others holding CEMP. I think the IV trial should succeed frankly.
CEMP and most of the other bios crashing of late was not all Hillary. She might have been the trigger
but the ballon was ready to burst anyway.
Was referring to the recent report in the hpertension journal that I posted the link for you on.
Was taking about the much touted "rapid" onset of actiion by ZS-9 versus Patiromer and the article's
questioned rationales for that. One reason stated was the natural inslulin generated by fasting patients
in the trials.The other rationale mentioned was the sodium produced by ZS-9 perhaps reacting and
producing sodium bicarbonate in the stomach thus giving a false read of K removal. They simply
suggested longer and more rigorous designed trials to see if K is actually being removed in the
rapid fashion so claimed by ZSPH.
The sodium in ZS9 could also be the source of the rapid onset of action that they claim, as the sodium is converted chemically into possibly sodium bicarbonate in the stomach and it could look like K is being reduced when actually it is not being removed from the system at all.