Early Administration of Tolvaptan Can Improve Survival in Patients with Cirrhotic Ascites
(1) Backgrounds and aim: Tolvaptan, a selective vasopressin type 2 receptor antagonist, was approved for ascites, and its short-term efficacy and safety have been confirmed. However, it is still unclear whether this novel drug may improve long-term survival rates in cirrhotic patients with ascites....
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| Veröffentlicht in: | Journal of clinical medicine 2021-01, Vol.10 (2), p.294 |
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| creator | Hosui, Atsushi Tanimoto, Takafumi Okahara, Toru Ashida, Munehiro Ohnishi, Kohsaku Wakahara, Yuhhei Kusumoto, Yukihiro Yamaguchi, Toshio Sueyoshi, Yuka Hirao, Motohiro Yamada, Takuya Hiramatsu, Naoki |
| description | (1) Backgrounds and aim: Tolvaptan, a selective vasopressin type 2 receptor antagonist, was approved for ascites, and its short-term efficacy and safety have been confirmed. However, it is still unclear whether this novel drug may improve long-term survival rates in cirrhotic patients with ascites. (2) Patients and methods: A total of 206 patients who responded insufficiently to conventional diuretics and were hospitalized for refractory ascites for the first time were retrospectively enrolled in this study. Among them, the first 57 consecutive patients were treated with conventional diuretics (the conventional therapy group); the latter 149 consecutive patients were treated with tolvaptan in addition to the conventional therapy (the tolvaptan group). (3) Results: The exacerbation of renal function was significantly milder in the tolvaptan group than in the conventional therapy group. The prognostic factors for survival in the tolvaptan group were being male, having hyperbilirubinemia, having a high blood urea nitrogen (BUN), and receiving high-dose furosemide at the start of tolvaptan treatment. The one-year and three-year cumulative survival rates were 67.8 and 45.3%, respectively, in patients with low-dose furosemide ( |
| doi_str_mv | 10.3390/jcm10020294 |
| format | Article |
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< 0.001). (4) Conclusion: Tolvaptan can improve survival in patients with cirrhotic ascites, especially when tolvaptan is started before high-dose furosemide administration.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10020294</identifier><identifier>PMID: 33466878</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Ascites ; Clinical medicine ; Creatinine ; Diuretics ; Drug dosages ; Liver cirrhosis ; Medical prognosis ; Multivariate analysis ; Sodium</subject><ispartof>Journal of clinical medicine, 2021-01, Vol.10 (2), p.294</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-cafce79b3f247d0dbbbc2e50dc1ee73db21cb2acc14dbf1a571be61488cfa09e3</citedby><cites>FETCH-LOGICAL-c409t-cafce79b3f247d0dbbbc2e50dc1ee73db21cb2acc14dbf1a571be61488cfa09e3</cites><orcidid>0000-0003-2845-3098 ; 0000-0003-3543-7467 ; 0000-0003-0777-8045</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830941/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830941/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33466878$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hosui, Atsushi</creatorcontrib><creatorcontrib>Tanimoto, Takafumi</creatorcontrib><creatorcontrib>Okahara, Toru</creatorcontrib><creatorcontrib>Ashida, Munehiro</creatorcontrib><creatorcontrib>Ohnishi, Kohsaku</creatorcontrib><creatorcontrib>Wakahara, Yuhhei</creatorcontrib><creatorcontrib>Kusumoto, Yukihiro</creatorcontrib><creatorcontrib>Yamaguchi, Toshio</creatorcontrib><creatorcontrib>Sueyoshi, Yuka</creatorcontrib><creatorcontrib>Hirao, Motohiro</creatorcontrib><creatorcontrib>Yamada, Takuya</creatorcontrib><creatorcontrib>Hiramatsu, Naoki</creatorcontrib><title>Early Administration of Tolvaptan Can Improve Survival in Patients with Cirrhotic Ascites</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>(1) Backgrounds and aim: Tolvaptan, a selective vasopressin type 2 receptor antagonist, was approved for ascites, and its short-term efficacy and safety have been confirmed. However, it is still unclear whether this novel drug may improve long-term survival rates in cirrhotic patients with ascites. (2) Patients and methods: A total of 206 patients who responded insufficiently to conventional diuretics and were hospitalized for refractory ascites for the first time were retrospectively enrolled in this study. Among them, the first 57 consecutive patients were treated with conventional diuretics (the conventional therapy group); the latter 149 consecutive patients were treated with tolvaptan in addition to the conventional therapy (the tolvaptan group). (3) Results: The exacerbation of renal function was significantly milder in the tolvaptan group than in the conventional therapy group. The prognostic factors for survival in the tolvaptan group were being male, having hyperbilirubinemia, having a high blood urea nitrogen (BUN), and receiving high-dose furosemide at the start of tolvaptan treatment. The one-year and three-year cumulative survival rates were 67.8 and 45.3%, respectively, in patients with low-dose furosemide (<40 mg/day) at the start of tolvaptan treatment. The prognosis was significantly better in the tolvaptan group with low-dose furosemide than in the conventional therapy group (
< 0.001). (4) Conclusion: Tolvaptan can improve survival in patients with cirrhotic ascites, especially when tolvaptan is started before high-dose furosemide administration.</description><subject>Ascites</subject><subject>Clinical medicine</subject><subject>Creatinine</subject><subject>Diuretics</subject><subject>Drug dosages</subject><subject>Liver cirrhosis</subject><subject>Medical prognosis</subject><subject>Multivariate analysis</subject><subject>Sodium</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkc1LAzEQxYMoKrUn7xLwIkg1X22yF6GUqgVBQT14Ckk2a1N2NzXJrvS_N-IH1YFhAvPj8SYPgGOMLigt0OXKNBghgkjBdsAhQZyPEBV0d-t9AIYxrlAuIRjBfB8cUMomE8HFIXiZq1Bv4LRsXOtiCio530JfwSdf92qdVAtnuRfNOvjewscu9K5XNXQtfMisbVOE7y4t4cyFsPTJGTiNxiUbj8Bepepoh99zAJ6v50-z29Hd_c1iNr0bGYaKNDKqMpYXmlaE8RKVWmtD7BiVBlvLaakJNpooYzArdYXVmGNtJ5gJYSqFCksH4OpLd93pxpYmWwqqluvgGhU20isn_25at5SvvpdcUFQwnAXOvgWCf-tsTLJx0di6Vq31XZTZV5H_bcxJRk__oSvfhTafJ8mEYcQQHotMnX9RJvgYg61-zWAkP1OTW6ll-mTb_y_7kxH9ACYOlQE</recordid><startdate>20210114</startdate><enddate>20210114</enddate><creator>Hosui, Atsushi</creator><creator>Tanimoto, Takafumi</creator><creator>Okahara, Toru</creator><creator>Ashida, Munehiro</creator><creator>Ohnishi, Kohsaku</creator><creator>Wakahara, Yuhhei</creator><creator>Kusumoto, Yukihiro</creator><creator>Yamaguchi, Toshio</creator><creator>Sueyoshi, Yuka</creator><creator>Hirao, Motohiro</creator><creator>Yamada, Takuya</creator><creator>Hiramatsu, Naoki</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2845-3098</orcidid><orcidid>https://orcid.org/0000-0003-3543-7467</orcidid><orcidid>https://orcid.org/0000-0003-0777-8045</orcidid></search><sort><creationdate>20210114</creationdate><title>Early Administration of Tolvaptan Can Improve Survival in Patients with Cirrhotic Ascites</title><author>Hosui, Atsushi ; Tanimoto, Takafumi ; Okahara, Toru ; Ashida, Munehiro ; Ohnishi, Kohsaku ; Wakahara, Yuhhei ; Kusumoto, Yukihiro ; Yamaguchi, Toshio ; Sueyoshi, Yuka ; Hirao, Motohiro ; Yamada, Takuya ; Hiramatsu, Naoki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409t-cafce79b3f247d0dbbbc2e50dc1ee73db21cb2acc14dbf1a571be61488cfa09e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Ascites</topic><topic>Clinical medicine</topic><topic>Creatinine</topic><topic>Diuretics</topic><topic>Drug dosages</topic><topic>Liver cirrhosis</topic><topic>Medical prognosis</topic><topic>Multivariate analysis</topic><topic>Sodium</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hosui, Atsushi</creatorcontrib><creatorcontrib>Tanimoto, Takafumi</creatorcontrib><creatorcontrib>Okahara, Toru</creatorcontrib><creatorcontrib>Ashida, Munehiro</creatorcontrib><creatorcontrib>Ohnishi, Kohsaku</creatorcontrib><creatorcontrib>Wakahara, Yuhhei</creatorcontrib><creatorcontrib>Kusumoto, Yukihiro</creatorcontrib><creatorcontrib>Yamaguchi, Toshio</creatorcontrib><creatorcontrib>Sueyoshi, Yuka</creatorcontrib><creatorcontrib>Hirao, Motohiro</creatorcontrib><creatorcontrib>Yamada, Takuya</creatorcontrib><creatorcontrib>Hiramatsu, Naoki</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hosui, Atsushi</au><au>Tanimoto, Takafumi</au><au>Okahara, Toru</au><au>Ashida, Munehiro</au><au>Ohnishi, Kohsaku</au><au>Wakahara, Yuhhei</au><au>Kusumoto, Yukihiro</au><au>Yamaguchi, Toshio</au><au>Sueyoshi, Yuka</au><au>Hirao, Motohiro</au><au>Yamada, Takuya</au><au>Hiramatsu, Naoki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early Administration of Tolvaptan Can Improve Survival in Patients with Cirrhotic Ascites</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2021-01-14</date><risdate>2021</risdate><volume>10</volume><issue>2</issue><spage>294</spage><pages>294-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>(1) Backgrounds and aim: Tolvaptan, a selective vasopressin type 2 receptor antagonist, was approved for ascites, and its short-term efficacy and safety have been confirmed. However, it is still unclear whether this novel drug may improve long-term survival rates in cirrhotic patients with ascites. (2) Patients and methods: A total of 206 patients who responded insufficiently to conventional diuretics and were hospitalized for refractory ascites for the first time were retrospectively enrolled in this study. Among them, the first 57 consecutive patients were treated with conventional diuretics (the conventional therapy group); the latter 149 consecutive patients were treated with tolvaptan in addition to the conventional therapy (the tolvaptan group). (3) Results: The exacerbation of renal function was significantly milder in the tolvaptan group than in the conventional therapy group. The prognostic factors for survival in the tolvaptan group were being male, having hyperbilirubinemia, having a high blood urea nitrogen (BUN), and receiving high-dose furosemide at the start of tolvaptan treatment. The one-year and three-year cumulative survival rates were 67.8 and 45.3%, respectively, in patients with low-dose furosemide (<40 mg/day) at the start of tolvaptan treatment. The prognosis was significantly better in the tolvaptan group with low-dose furosemide than in the conventional therapy group (
< 0.001). (4) Conclusion: Tolvaptan can improve survival in patients with cirrhotic ascites, especially when tolvaptan is started before high-dose furosemide administration.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>33466878</pmid><doi>10.3390/jcm10020294</doi><orcidid>https://orcid.org/0000-0003-2845-3098</orcidid><orcidid>https://orcid.org/0000-0003-3543-7467</orcidid><orcidid>https://orcid.org/0000-0003-0777-8045</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Ascites Clinical medicine Creatinine Diuretics Drug dosages Liver cirrhosis Medical prognosis Multivariate analysis Sodium |
| title | Early Administration of Tolvaptan Can Improve Survival in Patients with Cirrhotic Ascites |
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