Efficacy and safety of tolvaptan in heart failure patients with volume overload despite the standard treatment with conventional diuretics: a phase III, randomized, double-blind, placebo-controlled study (QUEST study).

Abstract

PURPOSE:

Diuretics are recommended to treat volume overload with heart failure (HF), however, they may cause serum electrolyte imbalance, limiting their use. Moreover, patients with advanced HF could poorly respond to these diuretics. In this study, we evaluated the efficacy and safety of Tolvaptan, a competitive vasopressin V2-receptor antagonist developed as a new drug to treat volume overload in HF patients.

METHODS:

A phase III, multicenter, randomized, double-blind, placebo-controlled parallel study was performed to assess the efficacy and safety of tolvaptan in treating HF patients with volume overload despite the use of conventional diuretics. One hundred and ten patients were randomly assigned to receive either placebo or 15 mg/day tolvaptan for 7 consecutive days.

RESULTS:

Compared with placebo, tolvaptan administered for 7 days significantly reduced body weight and improved symptoms associated with volume overload. The safety profile of tolvaptan was considered acceptable for clinical use with minimal adverse effects.

CONCLUSION:

Tolvaptan reduced volume overload and improved congestive symptoms associated with HF by a potent water diuresis (aquaresis).

• Authors: Masunori Matsuzaki, Masatsugu Hori, Tohru Izumi, Masatake Fukunami, Tolvaptan Investigators
• Journal: Cardiovascular drugs and therapy (Cardiovasc Drugs Ther) Vol. 25 Suppl 1 Pg. S33-45 (Dec 2011) ISSN: 1573-7241 [Electronic] United States
• PMID: 22120092 (Publication Type: Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Antidiuretic Hormone Receptor Antagonists
• Benzazepines
• Diuretics
• Arginine Vasopressin
• Tolvaptan
• Sodium
• Potassium

Topics

• Aged
• Aged, 80 and over
• Antidiuretic Hormone Receptor Antagonists
• Arginine Vasopressin (blood)
• Benzazepines (adverse effects, pharmacology, therapeutic use)
• Body Weight (drug effects)
• Diuretics (adverse effects, pharmacology, therapeutic use)
• Double-Blind Method
• Edema, Cardiac (blood, drug therapy)
• Female
• Heart Failure (blood, drug therapy)
• Humans
• Male
• Middle Aged
• Potassium (blood)
• Sodium (blood)
• Tolvaptan