PLATINUM Trial

PLATINUM was a prospective, randomised, double-blind, placebo-controlled, parallel-group trial conducted at 16 emergency department sites across the United States. The trial was terminated early because COVID-19 pandemic conditions made enrolment difficult, leaving it underpowered. The modified intention-to-treat population contained 111 patients: 53 in the patiromer group and 58 in the placebo group. Sixty participants per arm were calculated to provide 90% power, but the study planned to enrol 150 per arm to compensate for expected 60% attrition. All participants received standard combination therapy (dextrose, insulin, and albuterol) before receiving either patiromer or placebo. Eligible participants were adults aged 18 or older with serum potassium of at least 5.8 mEq/L presenting to a participating emergency department.