PMID- 37794713
OWN - NLM
STAT- MEDLINE
DCOM- 20231102
LR  - 20231102
IS  - 1747-4132 (Electronic)
IS  - 1747-4124 (Linking)
VI  - 17
IP  - 10
DP  - 2023 Jul-Dec
TI  - Efficacy and safety of tolvaptan in cirrhotic patients: a systematic review and 
      meta-analysis of randomized controlled trials.
PG  - 1041-1051
LID - 10.1080/17474124.2023.2267421 [doi]
AB  - BACKGROUND AND AIMS: Tolvaptan has been approved for the management of 
      cirrhosis-related complications according to the Japanese and Chinese practice 
      guidelines, but not the European or American practice guidelines in view of FDA 
      warning about its hepatotoxicity. This study aimed to systematically evaluate its 
      efficacy and safety in cirrhosis. METHODS: The PubMed, EMBASE, and Cochrane 
      library databases were searched to identify randomized controlled trials (RCTs) 
      evaluating the efficacy and/or safety of tolvaptan in cirrhosis. Risk ratios 
      (RRs) and weight mean differences (WMDs) were calculated. The incidence of common 
      adverse events (AEs) was pooled. RESULTS: Eight RCTs were included. Tolvaptan was 
      significantly associated with higher rates of improvement of ascites (RR = 1.49, 
      P < 0.001) and hyponatremia (RR = 1.80, P = 0.005) and incidence of any AEs 
      (RR = 1.18, P = 0.003), but not serious AEs (RR = 0.86, P = 0.410). Tolvaptan was 
      significantly associated with reductions in body weight (WMD = -1.30 kg, 
      P < 0.001) and abdominal circumference (WMD = -1.71 cm, P < 0.001), and increases 
      in daily urine volume (WMD = 1299.84 mL, P < 0.001) and serum sodium 
      concentration (WMD = 2.57 mmol/L, P < 0.001). The pooled incidences of dry mouth, 
      thirst, constipation, and pollakiuria were 16%, 24%, 6%, and 17%, respectively. 
      CONCLUSION: Short-term use of tolvaptan may be considered in cirrhotic patients 
      with ascites who have inadequate response to conventional diuretics and those 
      with hyponatremia.
FAU - Chai, Lu
AU  - Chai L
AD  - Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of 
      Northern Theater Command, Shenyang, China.
AD  - NMPA Key Laboratory for Research and Evaluation of Drug Regulatory Technology, 
      Shenyang Pharmaceutical University, Shenyang, China.
FAU - Li, Zhe
AU  - Li Z
AD  - Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of 
      Northern Theater Command, Shenyang, China.
AD  - NMPA Key Laboratory for Research and Evaluation of Drug Regulatory Technology, 
      Shenyang Pharmaceutical University, Shenyang, China.
FAU - Wang, Ting
AU  - Wang T
AD  - Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of 
      Northern Theater Command, Shenyang, China.
AD  - NMPA Key Laboratory for Research and Evaluation of Drug Regulatory Technology, 
      Shenyang Pharmaceutical University, Shenyang, China.
FAU - Wang, Ran
AU  - Wang R
AD  - Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of 
      Northern Theater Command, Shenyang, China.
FAU - Pinyopornpanish, Kanokwan
AU  - Pinyopornpanish K
AD  - Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 
      Chiang Mai, Thailand.
FAU - Cheng, Gang
AU  - Cheng G
AD  - NMPA Key Laboratory for Research and Evaluation of Drug Regulatory Technology, 
      Shenyang Pharmaceutical University, Shenyang, China.
FAU - Qi, Xingshun
AU  - Qi X
AUID- ORCID: 0000-0002-9448-6739
AD  - Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of 
      Northern Theater Command, Shenyang, China.
AD  - NMPA Key Laboratory for Research and Evaluation of Drug Regulatory Technology, 
      Shenyang Pharmaceutical University, Shenyang, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20231024
PL  - England
TA  - Expert Rev Gastroenterol Hepatol
JT  - Expert review of gastroenterology & hepatology
JID - 101278199
RN  - 21G72T1950 (Tolvaptan)
RN  - 0 (Antidiuretic Hormone Receptor Antagonists)
RN  - 0 (Benzazepines)
SB  - IM
MH  - Humans
MH  - Tolvaptan/adverse effects
MH  - *Hyponatremia/diagnosis/drug therapy/epidemiology
MH  - Antidiuretic Hormone Receptor Antagonists/adverse effects
MH  - Ascites/diagnosis/drug therapy/etiology
MH  - Benzazepines/adverse effects
MH  - Randomized Controlled Trials as Topic
MH  - Liver Cirrhosis/complications/diagnosis/drug therapy
OAB - [Figure: see text].
OABL- eng
OTO - NOTNLM
OT  - Tolvaptan
OT  - ascites
OT  - cirrhosis
OT  - hyponatremia
OT  - liver
EDAT- 2023/10/05 06:44
MHDA- 2023/11/02 12:47
CRDT- 2023/10/05 02:11
PHST- 2023/11/02 12:47 [medline]
PHST- 2023/10/05 06:44 [pubmed]
PHST- 2023/10/05 02:11 [entrez]
AID - 10.1080/17474124.2023.2267421 [doi]
PST - ppublish
SO  - Expert Rev Gastroenterol Hepatol. 2023 Jul-Dec;17(10):1041-1051. doi: 
      10.1080/17474124.2023.2267421. Epub 2023 Oct 24.