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Tolvaptan in Chinese cirrhotic patients with ascites: A randomized, placebo‐controlled phase 2 trial
Author(s) -
Wang Yong Feng,
Tang Jie Ting,
Han Tao,
Ding Hui Guo,
Ye Wei Jiang,
Wang Mao Rong,
Cheng Jun,
Yang Yong Ping,
Chen Cheng Wei,
Xie Qing,
Mao Qing,
Niu Jun Qi,
Wang Zheng Hua,
Wei Zhong,
Chen Ying Xuan,
Zeng Min De,
Mao Yi Min
Publication year - 2018
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12583
Subject(s) - tolvaptan , medicine , placebo , ascites , randomized controlled trial , gastroenterology , cirrhosis , adverse effect , peripheral edema , hyponatremia , urology , anesthesia , alternative medicine , pathology
Objective To evaluate tolvaptan as a novel therapeutic option for Chinese patients with liver cirrhosis‐associated ascites in a phase 2 clinical trial. Methods This randomized, double‐blind, placebo‐controlled, multicenter trial was conducted in patients with insufficient responses to combination therapies of an oral loop diuretic and an aldosterone antagonist. Reduction in body weight and abdominal circumference, increase in 24‐h cumulative urine volume and improvement in serum sodium level from baseline to the end of treatment in the tolvaptan groups (15 mg/day or 30 mg/day orally) were compared with those in the placebo group. Drug safety was also assessed. Results Sixty‐two patients were allocated to the placebo group, 56 to the tolvaptan 15‐mg group and 63 to the tolvaptan 30‐mg group. Their mean changes in body weight were ‐0.5 ± 1.6 kg, ‐2.1 ± 2.0 kg and ‐1.9 ± 2.0 kg, respectively. Body weight reductions in both tolvaptan groups were significantly greater than that in the placebo group (difference ‐1.6, 95% confidence interval [CI] ‐2.5 to ‐0.8, and difference ‐1.4, 95% CI, ‐2.2 to ‐0.7, both P < 0.0001). The administration of tolvaptan also significantly reduced the abdominal circumference, increased 24‐h cumulative urine volume and serum sodium level compared with placebo. The most common adverse events in the tolvaptan groups were constipation, diarrhea, dry mouth and thirst, with no severe adverse events observed. Conclusion Tolvaptan at 15 mg/day significantly reduced the body weight and abdominal circumference in patients with liver cirrhosis‐associated ascites, which needs to be confirmed in a phase 3 trial.