Experience with long-term administration of tolvaptan to patients with acute decompensated heart failure

Shunsuke Kiuchi, Takahiro Fujii, Shinji Hisatake, Takayuki Kabuki, Oka Takashi, Shintaro Dobashi, Takanori Ikeda
2017 Drug Discoveries & Therapeutics  
TLV. The current study investigated the efficacy and safety of long-term use of TLV. Subjects were 258 consecutive patients with HF who received TLV during hospitalization from January 2011 to March 2015. The rate of continuing administration of TLV was evaluated. Moreover, the one-year mortality rate and rate of re-hospitalization either with or without TLV were investigated. Results at discharge and one year later were compared for patients who continued to receive TLV one year after
more » ... year after discharge. Oral concomitant medications, blood pressures, heart rate, blood tests, chest X-ray and transthoracic echocardiography were investigated. In-hospital and one-year mortality rates were 15.9% and 27.8%, respectively. Moreover, the mortality rate and/or rate of re-hospitalization within one year was 54.4%. The rate of re-hospitalization for HF was significantly higher in patients who continued to receive TLV after discharge compared to patients who ceased receiving TLV after discharge (p < 0.001). However, the subjects who continued to receive TLV for up to one year after discharge tended to have a longer duration until re-hospitalization for HF and significantly decreased brain natriuretic peptide levels (577.6 ± 528.5 pg/mL to 397.3 ± 365.8 pg/mL, p = 0.015). Longterm use of TLV might delay re-hospitalization for HF in patients with severe HF. Largescale clinical studies are necessary to verify these results.
doi:10.5582/ddt.2017.01018 pmid:28626112 fatcat:7hzofpjncjfujm5eodtpb5rheq