Who Needs Longer Tolvaptan Treatment?

The vasopressin receptor 2 (V2) receptor antagonist tolvaptan is an aquaretic agent that has been approved for heart failure patients with volume overload in Japan. In this study (SMILE study), we investigated patient characteristics and effectiveness in both a 14 days and shorter treated group (14D...

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Bibliographic Details
Published inInternational heart journal Vol. 58; no. 1; p. 30
Main Authors Kinugawa, Koichiro, Inomata, Takayuki, Sato, Naoki, Yasuda, Moriyoshi, Shimakawa, Toshiyuki, Bando, Kosuke, Fukuta, Yasuhiko
Format Journal Article
LanguageEnglish
Published Japan 07.02.2017
Subjects
Aged
Aged, 80 and over
Antidiuretic Hormone Receptor Antagonists - administration & dosage
Antidiuretic Hormone Receptor Antagonists - adverse effects
Benzazepines - administration & dosage
Benzazepines - adverse effects
Female
Heart Failure - drug therapy
Humans
Male
Middle Aged
Product Surveillance, Postmarketing
Prospective Studies
Treatment Outcome
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Summary:The vasopressin receptor 2 (V2) receptor antagonist tolvaptan is an aquaretic agent that has been approved for heart failure patients with volume overload in Japan. In this study (SMILE study), we investigated patient characteristics and effectiveness in both a 14 days and shorter treated group (14DS) and 15 days and longer treated group (15DL). The results showed that the patients in the 15DL group had low cardiac output with intensive diuretic administration (ie, diuretic resistance). The congestive symptoms were greatly improved within 14 days of treatment in both the 14DS and 15DL groups. Further improvements in lower limb edema, pulmonary congestion, dyspnea, third sound, and rales after 2 weeks were statistically significant in the 15DL group, but the amount of improvement was subtle and the 15DL group might have consisted of a considerable number of "non-responders". Therefore, identifying "responders" by biomarkers and conducting a prospective randomized study is required to validate our findings.
ISSN:1349-3299