{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T07:16:37Z","timestamp":1781939797821,"version":"3.54.5"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006484","name":"Vifor Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      In patients with current or a history of hyperkalaemia, treatment with renin\u2013angiotensin\u2013aldosterone system inhibitors (RAASi) is often compromised. Patiromer, a novel potassium (K\n                      <jats:sup>+<\/jats:sup>\n                      ) binder, may improve serum K\n                      <jats:sup>+<\/jats:sup>\n                      levels and adherence to RAASi.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The DIAMOND trial will enroll \u223c820 patients with heart failure with reduced ejection fraction (HFrEF; ejection fraction \u226440%). Patients meeting the screening criteria will enter a single\u2010blinded run\u2010in phase where they will be started or continued on a mineralocorticoid receptor antagonist (MRA) titrated to 50\u2009mg\/day and other RAASi therapy to \u226550% target dose, and patiromer. Patiromer will be titrated up to a maximum three packs\/day (8.4\u00a0g\/pack) to achieve optimal doses of RAASi without hyperkalaemia. The run\u2010in phase will last up to 12\u2009weeks, following which patients will undergo double\u2010blind randomization in a 1:1 ratio to receive either continued patiromer or placebo (patiromer withdrawal). The primary endpoint is the mean difference in serum K\n                      <jats:sup>+<\/jats:sup>\n                      from randomization between patiromer and placebo arms. Secondary endpoints will include hyperkalaemia events with K\n                      <jats:sup>+<\/jats:sup>\n                      value &gt;5.5\u00a0mEq\/L, durable enablement of MRA at target dose, investigator\u2010reported adverse events of hyperkalaemia, hyperkalaemia\u2010related clinical endpoints and an overall RAASi use score (using a 0\u20138\u2010point scale) comprising all\u2010cause death, occurrence of cardiovascular hospitalization or usage of comprehensive heart failure medication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The DIAMOND trial is designed to determine if patiromer can favourably impact K\n                      <jats:sup>+<\/jats:sup>\n                      control in patients with HFrEF with hyperkalaemia or a history of hyperkalaemia leading to RAASi therapy compromise, and in turn improve RAASi use.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2386","type":"journal-article","created":{"date-parts":[[2021,11,20]],"date-time":"2021-11-20T05:20:22Z","timestamp":1637385622000},"page":"230-238","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Patiromer for the management of hyperkalaemia in patients receiving renin\u2013angiotensin\u2013aldosterone system inhibitors for heart failure: design and rationale of the\n                    <scp>DIAMOND<\/scp>\n                    trial"],"prefix":"10.1093","volume":"24","author":[{"given":"Javed","family":"Butler","sequence":"first","affiliation":[{"name":"Department of Medicine University of Mississippi  Jackson MS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Center for Cardiovascular Research (DZHK) partner site Berlin; Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq Jamal","family":"Siddiqi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.S.","family":"Coats","sequence":"additional","affiliation":[{"name":"University of Warwick  Warwick UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Dorigotti","sequence":"additional","affiliation":[{"name":"Vifor Pharma  Glattbrugg Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens, School of Medicine, Athens University Hospital Attikon  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Friede","sequence":"additional","affiliation":[{"name":"University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"},{"name":"DZHK (German Center for Cardiovascular Research), G\u00f6ttingen partner site  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udo\u2010Michael","family":"G\u00f6hring","sequence":"additional","affiliation":[{"name":"Vifor Pharma  Glattbrugg Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail N.","family":"Kosiborod","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease Saint Luke's Mid America Heart Institute and University of Missouri\u2010Kansas City  Kansas City MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars H.","family":"Lund","sequence":"additional","affiliation":[{"name":"Department of Medicine, Unit of Cardiology Karolinska Institute  Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Department of Cardiology University and Civil Hospital  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Moreno Quinn","sequence":"additional","affiliation":[{"name":"Vifor Pharma  Glattbrugg Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ileana L.","family":"Pi\u00f1a","sequence":"additional","affiliation":[{"name":"Central Michigan University  Mount Pleasant MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto J.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Santa Maria University Hospital, CAML, CCUL, Faculdade de Medicina da Universidade de Lisboa  Lisbon 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertram","family":"Pitt","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,12,9]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.592"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000435"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfz231"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.005428"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1757"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1079"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft134"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1182"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1793"},{"issue":"11","key":"e_1_2_4_11_1","first-page":"S212","article-title":"Evaluation of the treatment gap between clinical 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