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Background VS-505 (AP301), an acacia and ferric oxyhydroxide polymer, is a novel fiber-iron-based phosphate binder. This two-part Phase 2 study evaluated the tolerability, safety and efficacy of oral VS-505 administered three times daily with meals in treating hyperphosphatemia in chronic kidney disease (CKD) patients receiving maintenance hemodialysis (MHD). Methods In Part 1, patients received dose-escalated treatment with VS-505 2.25, 4.50 and 9.00 g/day for 2 weeks each, guided by serum phosphorus levels. In Part 2, patients received randomized, open-label, fixed-dosage treatment with VS-505 (1.50, 2.25, 4.50 or 6.75 g/day) or sevelamer carbonate 4.80 g/day for 6 weeks. The primary efficacy endpoint was the change in serum phosphorus. Results The study enrolled 158 patients (Part 1: 25; Part 2: 133), with 130 exposed to VS-505 in total. VS-505 was well tolerated. The most common adverse events were gastrointestinal disorders, mainly feces discolored (56%) and diarrhea (15%; generally during Weeks 1–2 of treatment). Most gastrointestinal disorders resolved without intervention, and none was serious. In Part 1, serum phosphorus significantly improved (mean change −2.0 mg/dL; 95% confidence interval −2.7, −1.4) after VS-505 dose escalation. In Part 2, serum phosphorus significantly and dose-dependently improved in all VS-505 arms, with clinically meaningful reductions with VS-505 4.50 and 6.75 g/day, and sevelamer carbonate 4.80 g/day [mean change −1.6 (−2.2, −1.0), −1.8 (−2.4, −1.2) and −1.4 (−2.2, −0.5) mg/dL, respectively]. In both parts, serum phosphorus reductions occurred within 1 week of VS-505 initiation, returning to baseline within 2 weeks of VS-505 discontinuation. Conclusion VS-505, a novel phosphate binder, was well tolerated with a manageable safety profile, and effectively and dose-dependently reduced serum phosphorus in CKD patients with hyperphosphatemia receiving MHD. Clinical Trial registration number NCT04551300 [ABSTRACT FROM AUTHOR]

Besides their limited preservation capacity and low biosafety, traditional fruit preservation procedures exacerbate "white pollution" because they utilize excessive plastic. Herein, an environmentally friendly one-pot method was developed to obtain degradable polyvinyl alcohol (PVA), where the hydroxyl radicals generated through the reaction between hydrogen peroxide (H2O2) and iron ions functioned to oxidize PVA. The oxidized PVA (OPVA-1.0) with abundant ketone groups, reduced crystallinity, and short molecular chains was completely degraded into H2O and CO2 after being buried in the soil for ∼60 days. An improvement in its degradation rate did not weaken the mechanical properties of OPVA-1.0 compared to other modified PVA films because the adverse effect of decreased crystallinity on its mechanical performance was offset by its ion coordination. Alternatively, the tensile strength or toughness of OPVA-1.0 was enhanced due to its internal multi-level interactions including molecular chain entanglement, hydrogen bonding, and metal coordination bonds. More interestingly, OPVA-1.0 was water-welded into various products in a recyclable way owing to its reversible physical bonds, where it was sprayed, dipped, or brushed conformally onto different perishable fruits to delay their ripening by 5–14 days. Based on the cellular biocompatibility and biosafety evaluations in mice, OPVA-1.0 obtained by the facile oxidation strategy was demonstrated to alleviate "white pollution" and delay the ripening of fruits effectively. [ABSTRACT FROM AUTHOR]