Potential Effectiveness of Tolvaptan to Improve Ascites Unresponsive to Standard Diuretics and Overall Survival in Patients with Decompensated Liver Cirrhosis

Background and Objective After tolvaptan was approved for the treatment of cirrhosis patients with ascites, only a few studies have reported its efficacy in the real clinical setting, and no studies have reported its contribution to overall survival. This study clarified the clinical outcomes of tol...

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Bibliographic Details
Published in:Clinical drug investigation 2016-10, Vol.36 (10), p.829-835
Main Authors: Yamada, Tomoharu, Ohki, Takamasa, Hayata, Yuki, Karasawa, Yuki, Kawamura, Satoshi, Ito, Daisaku, Kojima, Kentaro, Seki, Michiharu, Toda, Nobuo, Tagawa, Kazumi
Format: Article
Language:English
Subjects:
Aged
Ascites - drug therapy
Benzazepines - therapeutic use
Carcinoma, Hepatocellular - pathology
Diuretics - therapeutic use
Female
Humans
Hyponatremia - epidemiology
Internal Medicine
Liver Cirrhosis - drug therapy
Liver Neoplasms - pathology
Male
Medicine
Medicine & Public Health
Middle Aged
Original Research Article
Pharmacology/Toxicology
Pharmacotherapy
Retrospective Studies
Survival Rate
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Summary:Background and Objective After tolvaptan was approved for the treatment of cirrhosis patients with ascites, only a few studies have reported its efficacy in the real clinical setting, and no studies have reported its contribution to overall survival. This study clarified the clinical outcomes of tolvaptan treatment in terms of improving ascites unresponsive to standard diuretics (AUS) and overall survival. Methods We retrospectively enrolled 80 decompensated cirrhosis patients with AUS who were administered tolvaptan from October 2012 to December 2014. The patients were divided into two groups according to ascites improvement. We compared laboratory results and overall survival and analyzed factors that affected overall survival. Results Of the 80 patients, 59 (73.8 %) were male and the median age was 70 years. Thirty-nine (48.8 %) patients were Child–Pugh class C, and 36 (45.0 %) had advanced hepatocellular carcinoma (HCC). Tolvaptan was effective in 48 (60.0 %) patients with an average 3.8 kg weight reduction and ineffective in 32 (40.0 %) patients. The cumulative survival rate differed significantly between the two groups ( p  
ISSN:1173-2563
1179-1918
DOI:10.1007/s40261-016-0434-7