The shortterm and longterm effects of tolvaptan

Authors: Bo Xiong Yuwen Huang Jie Tan Yuanqing Yao Chunbin Wang Jun Qian Shunkang Rong Shimin Deng Yin Cao Yanke Zou Jing Huang

Publish Date: 2015/09/03

Volume: 20, Issue: 6, Pages: 633-642

PDF Link

Abstract

A comprehensive evaluation of the benefits of tolvaptan for the management of heart failure HF is lacking The objective of this metaanalysis was to assess the shortterm and longterm effects of tolvaptan in patients with HF Articles were searched from PubMed MEDLINE and Cochrane Library before March 31 2015 Randomized controlled trials enrolling adult HF patients and reporting the allcause mortality cardiac events body weight change or changes of serum electrolytes including sodium potassium and creatinine were included in our metaanalysis Ten studies covering 5574 patients met the inclusion criteria Based on the data of metaanalysis tolvaptan had no impact on the allcause mortality relative risk RR 096 95  confidence interval CI 087–106 P = 040 and incidence of cardiac events RR 103 95  CI 096–111 P = 040 of HF patients Furthermore in comparison with control treatments tolvaptan significantly decreased the body weight weight mean difference WMD −087 95  CI −103 to −071 P  0001 and statistically increased serum sodium WMD 258 95  CI −183 to 333 P  0001 without any change in serum potassium WMD 001 95  CI −003 to 005 P = 0577 However serum creatinine may be increased slightly by tolvaptan WMD 005 95  CI 003–007 P  0001 This metaanalysis suggests that in HF patients tolvaptan may not bring longterm benefits but it effectively improves the volume overload and hyponatremia without obvious increases in serum potassium and creatinine Hence tolvaptan is likely to be a promising diuretic for the treatment of HF

Keywords: