title: Predictors of the Effect of Tolvaptan on the Prognosis of Cirrhosis.
abstract: Objective Tolvaptan was first approved for use for cirrhosis in Japan in September 2013. The aim of the study was to examine the effect of tolvaptan, a vasopressin V2 receptor antagonist, on the prognosis of cirrhosis. Methods The effect of tolvaptan was evaluated in 26 patients with cirrhosis treated at our hospital from September 2013 to April 2015. Results The primary disease was hepatitis C in 20 patients, hepatitis B in 2, nonalcoholic steatohepatitis in 2 and others in 2; and 12 had hepatocellular carcinoma. The Child-Pugh score was 9.7±1.6 and the serum albumin level was 2.53±0.44 g/dL. Body weight decreased from 55.5±11.8 kg before administration to 52.1±14.7 kg after 7 days of tolvaptan treatment. After 7 days, patients with weight loss ≥2 kg (n=16, mean decrease of 4.3±2.3 kg) had significantly lower blood urea nitrogen (24.2±14.4 vs. 36.1±11.4 mg/dL) and serum creatinine (1.1±0.5 vs. 1.5±0.7 mg/dL) levels and decreased urine osmolality 4 h after the administration of tolvaptan (236±96 vs. 364±122 mOsm/kg) compared with patients with weight loss <2 kg (n=10, mean increase of +0.7±2.1 kg) (all p<0.05). The prognosis was significantly better in the group with weight loss ≥2 kg. Conclusion The effect of tolvaptan on the renal function is likely to improve the prognosis of patients with cirrhosis if the drug is started at a stage in which the renal function is maintained.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Iwamoto
authors.forename: Masaki
authors.initials: M
authors.lastname: Maeda
authors.forename: Takuro
authors.initials: T
authors.lastname: Hisanaga
authors.forename: Issei
authors.initials: I
authors.lastname: Saeki
authors.forename: Koichi
authors.initials: K
authors.lastname: Fujisawa
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Isao
authors.initials: I
authors.lastname: Hidaka
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Taro
authors.initials: T
authors.lastname: Takami
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
mesh_terms: D000284:Administration, Oral; D000368:Aged; D065092:Antidiuretic Hormone Receptor Antagonists / Q000008:administration & dosage*; D001552:Benzazepines / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008103:Liver Cirrhosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D011379:Prognosis; D000077602:Tolvaptan
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D000077602:Tolvaptan