Version 1
: Received: 25 December 2023 / Approved: 26 December 2023 / Online: 26 December 2023 (10:26:07 CET)
How to cite:
Dani, A.; Shah, K.; Sahni, T.; Desai, D. Role of Tolvaptan in Heart Failure: A Meta-Analysis. Preprints2023, 2023121985. https://doi.org/10.20944/preprints202312.1985.v1
Dani, A.; Shah, K.; Sahni, T.; Desai, D. Role of Tolvaptan in Heart Failure: A Meta-Analysis. Preprints 2023, 2023121985. https://doi.org/10.20944/preprints202312.1985.v1
Dani, A.; Shah, K.; Sahni, T.; Desai, D. Role of Tolvaptan in Heart Failure: A Meta-Analysis. Preprints2023, 2023121985. https://doi.org/10.20944/preprints202312.1985.v1
APA Style
Dani, A., Shah, K., Sahni, T., & Desai, D. (2023). Role of Tolvaptan in Heart Failure: A Meta-Analysis. Preprints. https://doi.org/10.20944/preprints202312.1985.v1
Chicago/Turabian Style
Dani, A., Tanvi Sahni and Dev Desai. 2023 "Role of Tolvaptan in Heart Failure: A Meta-Analysis" Preprints. https://doi.org/10.20944/preprints202312.1985.v1
Abstract
BackgroundHeart failure is a life-threatening disease affecting millions worldwide. Tolvaptan is the first FDA-approved orally active nonpeptide vasopressin 2 receptor antagonist to be used in hypervolemic hyponatremia, heart failure, cirrhosis, etc. In clinical trials, tolvaptan impacts short-term in increasing water excretion, and restoring Na+ and dyspnoea. Aims & ObjectivesThe objective is to analyze the outcomes of tolvaptan in existing cases of heart failure. MethodologyWe conducted a database search of the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials and RCTs till 1st September 2019 were included following PRISMA guidelines after being matched with inclusion and exclusion criteria. 21 RCTs were included with 7,357 patients receiving tolvaptan and 7,273 patients being the control group. We used the MESH strings such as 'tolvaptan', 'vasopressin V2 receptor blocker', 'acute heart failure', and 'acute decompensated heart failure'. ResultsMeta-analysis showed that Tolvaptan was associated with a significant reduction in edema (RR = 1.05, 95% CI = 1.019-1.081, p=0.001) and significant body weight reduction (Control-SMD = -0.489, 95% CI =-0.637 to -0.342, p<0.001)&(Placebo-SMD = -0.425, 95% CI = -0.425 to -0.382, p<0.001) It shows significant decrease in serum sodium levels (SMD = 0.678, 95% CI = 0.609 to 0.748, p<0.001). There was no significant decrease in all-cause mortality (Control-RR = 0.855, 95% CI 0.470 to 1.555, p=0.607)(Placebo-RR= 0.972, 95% CI = 0.879-1.074, p=0.575). Results for Worsening renal function in heart failure (Placebo-RR = 0.798 95% CI 0.619 to 1.028, p=0.081)(Control-RR = 1.349, 95% CI=0.927-1.964, p=0.118). ConclusionAlthough tolvaptan may significantly reduce edema, congestive symptoms and decreased body weight, it has no impact on all-cause mortality and worsening renal function in heart failure.
Keywords
Tolvaptan; ADHF; PRISMA; VRA
Subject
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
