A Study On Tolvaptan, An Oral Vasopressin Antagonist, in Treatment of hyponatremia in cirrhosis

Dr. Himanshu Kumar

Volume : VIII, Issue : III, March - 2019

A Study On Tolvaptan, An Oral Vasopressin Antagonist, in Treatment of hyponatremia in cirrhosis

Dr. Himanshu Kumar

Abstract :

Tolvaptan is a vasopressin V2–receptorantagonist that improves serum sodium concentration byincreasing renal solute–free water excretion. Specific data onthe safety and efficacy of tolvaptan in patients with cirrhosisand hyponatremia has not been exclusively evaluated. Methods: This Study examined cirrhotic patients with hyponatremiawho received 15 mg oral tolvaptan (n = 30; increased to 30 or60 mg ifneeded)orplacebo (n = 25) once–dailyfor30 days.Atbase–line, 46% had mild hyponatremia (serum sodium 130–134 mmol/L), 54% had marked hyponatremia (serum sodium <130 mmol/L). Results: Tolvaptan was effective in raising serum sodium. Patients treated with tolvaptan showed greater increase in serum sodium level. This superiority was maintained afterstratification by baseline hyponatremia (mild and marked).Hyponatremia recurred 7 days after discontinuation of tolvaptan. Major side effectsdue to tolvaptan were dry mouth and thirst. Gastrointestinalbleeding occurred in 10% and 2% of patients in the tolvaptanand placebo group, respectively . Adverse event rates,withdrawals, and deaths were similar in both groups. Conclusions:One month of tolvaptan therapy improved serumsodium levels and patient–reported health status in cirrhoticpatients with hyponatremia. Hyponatremia recurred in tolvaptan–treated patients after discontinuation