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Tolvaptan

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https://www.readbyqxmd.com/read/28943585/the-outcome-of-cirrhotic-patients-with-ascites-is-improved-by-the-normalization-of-the-serum-sodium-level-by-tolvaptan
#1
Tomomi Kogiso, Mutsuki Kobayashi, Kuniko Yamamoto, Yuichi Ikarashi, Kazuhisa Kodama, Makiko Taniai, Nobuyuki Torii, Etsuko Hashimoto, Katsutoshi Tokushige
Objectives Hyponatremia is frequently observed in patients with decompensated liver cirrhosis and it is also related to a poor prognosis. The vasopressin V2-receptor antagonist tolvaptan is used to treat cirrhotic patients with ascites and increases the serum sodium (Na) level. In this study, we investigated (i) whether or not correction of the Na level improves the prognosis of cirrhotic patients with ascites and (ii) predictors of normalization of the serum Na level after tolvaptan therapy. Methods This was a single-center retrospective study...
September 25, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28939928/acute-heart-failure-an-unmet-medical-need
#2
REVIEW
A G Rigopoulos, C Bakogiannis, R de Vecchis, S Sakellaropoulos, M Ali, M Teren, M Matiakis, C Tschoepe, M Noutsias
Despite recent advances in the management of heart failure with reduced ejection fraction (HFrEF), the burden of acute heart failure (AHF) remains significant with a high morbidity and mortality that has not been improved by any treatment modality. A meta-analysis summarized the study results on the effects of tolvaptan on AHF, which failed to demonstrate an improvement in short-term and long-term mortality, length of hospital stay and reduced frequency of worsening heart failure (WHF). Similar trial results were also reported in other AHF studies, such as the ASCEND-HF and the RELAX-AHF-2 trials...
September 22, 2017: Herz
https://www.readbyqxmd.com/read/28905441/the-vasopressin-system-new-insights-for-patients-with-kidney-diseases-epidemiological-evidence-and-therapeutic-perspectives
#3
REVIEW
W F Clark, O Devuyst, R Roussel
People with chronic kidney disease (CKD) are at risk of severe outcomes, such as end-stage renal disease or cardiovascular disease, and CKD is a globally increasing health burden with a high personal and economic cost. Despite major progresses in prevention and therapeutics in last decades, research is still needed to reverse this epidemic trend. The regulation of water balance and the state of activation of the vasopressin system have emerged as factors tightly associated with kidney health, in the general population but also in specific conditions; among them, various stages of CKD, diabetes and autosomal dominant polycystic kidney disease (ADPKD)...
October 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28898297/effects-and-safety-of-oral-tolvaptan-in-patients-with-congestive-heart-failure-a-systematic-review-and-network-meta-analysis
#4
Mei-Yi Wu, Tzu-Ting Chen, Ying-Chun Chen, Der-Cherng Tarng, Yun-Chun Wu, Hsien-Ho Lin, Yu-Kang Tu
AIMS: Several studies reported treatment benefits of tolvaptan in patients with congestive heart failure (CHF). However, the optimal dosage remains unclear. We aimed to compare different dosage of tolvaptan to determine the optimal dosage in terms of the efficacy and safety. METHODS: We searched MEDLINE, PubMed, EMBASE, Cochrane CENTRAL and ClinicalTrials.gov through Aug 31, 2016. Randomized controlled trials (RCTs) comparing tolvaptan of different dosages or to placebo in patients with CHF were included...
2017: PloS One
https://www.readbyqxmd.com/read/28889231/favorable-effects-of-early-tolvaptan-administration-in-very-elderly-patients-after-repeat-hospitalizations-for-acute-decompensated-heart-failure
#5
Masaki Kinoshita, Hideki Okayama, Tetsuya Kosaki, Saki Hosokawa, Go Kawamura, Tatsuya Shigematsu, Tatsunori Takahashi, Yoshitaka Kawada, Go Hiasa, Tadakatsu Yamada, Hiroshi Matsuoka, Yukio Kazatani
Tolvaptan (TLV) is an oral selective vasopressin 2 receptor antagonist that acts on the distal nephrons, causing a loss of electrolyte-free water. To date, its early administration in very elderly patients after repeat hospitalizations for acute decompensated heart failure (ADHF) despite receiving optimal medical therapy has not been evaluated. Fifty-six ADHF patients who were >80 years old and had been repeatedly hospitalized were retrospectively enrolled in this study. Twenty-five patients (14 men; mean age 86...
September 9, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28883307/tolvaptan-in-the-very-elderly-with-acute-decompensated-heart-failure-a-therapeutic-option-worth-of-consideration
#6
EDITORIAL
Gjin Ndrepepa
No abstract text is available yet for this article.
September 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28883217/safety-and-efficacy-of-long-term-use-of-tolvaptan-in-patients-with-heart-failure-and-chronic-kidney-disease
#7
Yusuke Uemura, Rei Shibata, Kenji Takemoto, Tomohiro Uchikawa, Masayoshi Koyasu, Shinji Ishikawa, Ryo Imai, Yuta Ozaki, Takashi Watanabe, Tsubasa Teraoka, Masato Watarai, Toyoaki Murohara
BACKGROUND: We assessed the long-term safety and efficacy of tolvaptan in 102 patients with heart failure (HF) and chronic kidney disease (CKD). Median follow-up duration was 1.6 years (1.0-4.4 years).Methods and Results:One patient discontinued tolvaptan because of hypernatremia. There were no changes in renal function or electrolytes during the 1-year follow-up. The cardiac-related death-free or HF-related hospitalization-free survival rate was significantly higher in patients receiving tolvaptan than in propensity score-matched patients who did not receive tolvaptan...
September 5, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28839438/efficacy-of-tolvaptan-for-the-patients-with-advanced-hepatocellular-carcinoma
#8
Masayuki Miyazaki, Masayoshi Yada, Kosuke Tanaka, Takeshi Senjyu, Takeshi Goya, Kenta Motomura, Motoyuki Kohjima, Masaki Kato, Akihide Masumoto, Kazuhiro Kotoh
AIM: To investigate the factors influenced the efficacy of tolvaptan (TLV) in liver cirrhosis. METHODS: We retrospectively enrolled 61 consecutive patients with refractory hepatic ascites. All of them had been treated with furosemide and spironolactone before admission, and treated with TLV for 7 d in our hospital. The effect of TLV was defined by the rate of body weight loss, and the factors that influenced TLV efficacy were analyzed using multiple regression. RESULTS: Coexistent hepatocellular carcinoma (HCC) was the only significant predictive variable that attenuated the efficacy of TLV...
August 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28835586/effects-of-additive-tolvaptan-vs-increased-furosemide-on-heart-failure-with-diuretic-resistance-and-renal-impairment%C3%A3-results-from-the-k-star-study
#9
Takayuki Inomata, Yuki Ikeda, Keisuke Kida, Yugo Shibagaki, Naoki Sato, Yuji Kumagai, Hisahito Shinagawa, Junya Ako, Tohru Izumi
BACKGROUND: Although diuretic resistance leading to residual congestion is a known predictor of a poorer heart failure (HF) prognosis, better therapeutic strategies for effective and safe decongestion have not been established.Methods and Results:In this study, 81 HF patients with fluid retention (despite taking ≥40 mg/day furosemide (FUR)), with an estimated glomerular filtration rate <45 mL/min/1.73 m(2), were randomized into 2 groups and administered either ≤15 mg/day additive tolvaptan (TLV) or ≤40 mg/day increased FUR for 7 days...
August 22, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28815407/efficacy-and-safety-of-the-early-use-of-v2-receptor-antagonists-in-elderly-patients-with-decompensated-heart-failure
#10
Ryuichi Matsukawa, Toru Kubota, Masanori Okabe, Yusuke Yamamoto, Hiroshi Meno
We recently reported that the early initiation of tolvaptan in congestive heart failure shortened the hospital stay and reduced the rate of in-hospital death. However, whether or not these results apply to elderly patients with congestive heart failure is unclear. We performed a sub-analysis of our previous study. Among the 102 patients in that study, we retrospectively analyzed the elderly patients >75 years of age treated with tolvaptan. First, we analyzed the efficacy of early tolvaptan use in these patients...
August 16, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28810844/effect-of-tolvaptan-on-renal-handling-of-water-and-sodium-gfr-and-central-hemodynamics-in-autosomal-dominant-polycystic-kidney-disease-during-inhibition-of-the-nitric-oxide-system-a-randomized-placebo-controlled-double-blind-crossover-study
#11
Safa Al Therwani, My Emma Sofie Malmberg, Jeppe Bakkestroem Rosenbaek, Jesper Noergaard Bech, Erling Bjerregaard Pedersen
BACKGROUND: Tolvaptan slows progression of autosomal dominant polycystic kidney disease (ADPKD) by antagonizing the vasopressin-cAMP axis. Nitric oxide (NO) stimulates natriuresis and diuresis, but its role is unknown during tolvaptan treatment in ADPKD. METHODS: Eighteen patients with ADPKD received tolvaptan 60 mg or placebo in a randomized, placebo-controlled, double blind, crossover study. L-NMMA (L-NG-monomethyl-arginine) was given as a bolus followed by continuous infusion during 60 min...
August 15, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28803333/low-dose-tolvaptan-pk-pd-comparison-of-patients-with-hyponatremia-due-to-syndrome-of-inappropriate-antidiuretic-hormone-secretion-to-healthy-adults
#12
Susan E Shoaf, Patricia Bricmont, Ann Dandurand
PURPOSE: Tolvaptan (TLV) is indicated to treat hyponatremia due to syndrome of inappropriate diuretic hormone (SIADH) in Europe. Treatment is to be initiated at 15 mg QD but post-approval reporting indicates increasing use of 7.5 mg as the starting dose. Physicians believe 7.5 mg is effective and has a lower incidence of overly rapid correction of serum sodium. METHODS: Single TLV doses of 3.75, 7.5, and 15 mg were administered to 14 healthy adults in a crossover design and to 29 subjects ≥18 years with SIADH and serum sodium between 120 and 133 mmol/L in a parallel-group design...
August 12, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28777097/clinical-utility-of-early-use-of-tolvaptan-in-very-elderly-patients-with-acute-decompensated-heart-failure
#13
Hiroki Niikura, Raisuke Iijima, Hitoshi Anzai, Norihiro Kogame, Ryo Fukui, Hiroki Takenaka, Nobuyuki Kobayashi
OBJECTIVE: The establishment of an optimal strategy for elderly patients with acute decompensated heart failure (ADHF) is currently an important issue. Particularly in very elderly (VE) patients, ADHF is associated with a poor prognosis. We therefore aimed to evaluate the efficacy and safety of the early use of tolvaptan (TLV) in VE patients. METHODS: Of 245 patients with ADHF admitted between March 2013 and July 2014, we prospectively enrolled 111 patients with TLV first administered within 24 h of hospitalization...
August 2, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28775063/current-management-of-hyponatremia-in-acute-heart-failure-a-report-from-the-hyponatremia-registry-for-patients-with-euvolemic-and-hypervolemic-hyponatremia-hn-registry
#14
Mark E Dunlap, Paul J Hauptman, Alpesh N Amin, Sandra L Chase, Joseph A Chiodo, Jun R Chiong, Joseph F Dasta
BACKGROUND: Hyponatremia (HN) occurs commonly in patients with acute heart failure and confers a worse prognosis. Current HN treatment varies widely, with no consensus. This study recorded treatment practices currently used for patients hospitalized with acute heart failure and HN. METHODS AND RESULTS: Data were collected prospectively from 146 US sites on patients hospitalized with acute heart failure and HN (serum sodium concentration [Na(+)] ≤130 mEq/L) present at admission or developing in the hospital...
August 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28759864/characterization-of-the-phase-i-and-phase-ii-metabolic-profile-of-tolvaptan-by-in-vitro-studies-and-liquid-chromatography-mass-spectrometry-profiling-relevance-to-doping-control-analysis
#15
Monica Mazzarino, Valeria Buccilli, Xavier de la Torre, Ilaria Fiacco, Amelia Palermo, Daniele Ughi, Francesco Botrè
Phase I and phase II biochemical reactions involved in the biotransformation pathways of tolvaptan were characterized by LC-MS-based techniques and in vitro models to identify the most appropriate marker(s) of intake. The effects of physiological and non-physiological factors on the metabolic profile of tolvaptan were also evaluated. In vitro approaches were based on the use of pooled human liver microsomes and recombinant isoforms of cytochrome P450 and uridine diphospho glucuronosyl-transferase. Sample preparation included liquid/liquid extraction at neutral pH with tert-butyl methyl-ether...
October 25, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28751810/effectiveness-of-tolvaptan-monotherapy-and-low-dose-furosemide-tolvaptan-combination-therapy-for-hepatoprotection-and-diuresis-in-a-rat-cirrhotic-model
#16
Norikazu Tanabe, Taro Takami, Koichi Fujisawa, Toshihiko Matsumoto, Naoki Yamamoto, Isao Sakaida
Spironolactone and furosemide, which are used to treat ascites associated with decompensated cirrhosis, are ineffective in treating refractory ascites. Hence, combination therapy with tolvaptan, a vasopressin V2 receptor antagonist, has been approved in Japan. Tolvaptan monotherapy and combination therapy with furosemide inhibit fibrosis in cardiac remodeling; hence, we examined these therapies in a rat cirrhotic model, including their usefulness in inhibiting hepatic fibrosis. In the present study, we used a model of hepatic fibrosis induced by a choline-deficient l-amino-acid-defined diet + diethylnitrosamine...
July 2017: Journal of Clinical Biochemistry and Nutrition
https://www.readbyqxmd.com/read/28725324/cardiorenal-syndrome-role-of-arginine-vasopressin-and-vaptans-in-heart-failure
#17
REVIEW
Poornima Vinod, Vinod Krishnappa, Abigail M Chauvin, Anshika Khare, Rupesh Raina
Heart and kidney failure continued to be of increasing prevalence in today's society, and their comorbidity has synergistic effect on the morbidity and mortality of patients. Cardiorenal syndrome (CRS) is a complex disease with multifactorial pathophysiology. Better understanding of this pathophysiological network is crucial for the successful intervention to prevent advancement of the disease process. One of the major factors in this process is neurohormonal activation, predominantly involving renin-angiotensin-aldosterone system (RAAS) and arginine vasopressin (AVP)...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28701677/mechanisms-of-diuresis-for-acute-decompensated-heart-failure-by-tolvaptan
#18
RANDOMIZED CONTROLLED TRIAL
Hidetsugu Nomoto, Yasuhiro Satoh, Mayu Kamiyama, Kento Yabe, Mayumi Masumura, Atsushi Sakakibara, Shu Yamashita, Masahito Suzuki, Tomoyo Sugiyama, Tetsuo Oumi, Masakazu Ohno, Yoshihide Takahashi, Mitsuaki Isobe
Tolvaptan, a vasopressin type 2 receptor antagonist, does not affect kidney circulation or cause worsening of renal function (WRF) in patients with acute decompensated heart failure (ADHF). Bioelectrical impedance analysis (BIA) can be used to evaluate intravascular volume by calculating the ratio of extracellular water (ECW) to intracellular water (ICW). There have been no reports examining the mechanisms of tolvaptan-induced diuresis using BIA. We investigated whether tolvaptan decreases excess volume while maintaining intravascular volume in ADHF patients...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28698994/prognostic-importance-of-sodium-level-trajectory-in-acute-heart-failure
#19
Yuya Matsue, Kenji Yoshioka, Makoto Suzuki, Sho Torii, Satoshi Yamaguchi, Seiji Fukamizu, Yuichi Ono, Hiroyuki Fujii, Takeshi Kitai, Toshihiko Nishioka, Kaoru Sugi, Yuko Onishi, Makoto Noda, Nobuyuki Kagiyama, Yasuhiro Satoh, Kazuki Yoshida, Steven R Goldsmith
Low sodium levels are strongly associated with poor prognosis in acute heart failure (AHF); however, the prognostic impact of the sodium level trajectory overtime has not been determined. A secondary analysis of the AQUAMARINE study in which patients with AHF and renal impairment were randomized to receive either tolvaptan or conventional treatment was performed. Sodium levels were evaluated at the baseline and at 6, 12, 24, and 48 h. We defined 'sodium dipping' as sodium level falling below the baseline level at any time point...
July 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28694395/use-of-tolvaptan-in-patients-hospitalized-for-worsening-chronic-heart-failure-with-severe-hyponatremia-the-initial-experience-at-a-single-center-in-turkey
#20
Saim Sağ, Aysel Aydın Kaderli, Abdülmecit Yıldız, Bülent Cuma Gül, Bülent Özdemir, İbrahim Baran, Sümeyye Güllülü, Ali Aydınlar, Yüksel Çavuşoğlu
OBJECTIVE: The aim of the present study was to assess the efficacy and safety of tolvaptan for severe hyponatremia (SH) in hypervolemic heart failure (HF) patients within daily clinical practice. METHODS: We restrospectively reviewed our database on tolvaptan as an add-on treatment in hypervolemic patients admitted to our clinic due to deterioration of HF and having hyponatremia resistant to standard therapy. Severe hyponatremia was defined as serum sodium concentration ≤125 mEq/L...
July 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
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