Efficacy and safety of tolvaptan for pediatric patients with congestive heart failure. Multicenter survey in the working group of the Japanese Society of PEdiatric Circulation and Hemodynamics (J-SPECH)

Higashi, Kouji; Murakami, Tomoaki; Ishikawa, Yuichi; Itoi, Toshiyuki; Ohuchi, Hideo; Kodama, Yoshihiko; Honda, Takashi; Masutani, Satoshi; Yamazawa, Hirokuni; Senzaki, Hideaki; Ishikawa, Shiro

doi:10.1016/j.ijcard.2015.12.003

Cited by 29 publications

(32 citation statements)

References 14 publications

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“…To date, there are few data regarding the use of vaptans in paediatrics ( 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ). The youngest patient treated was 2 years and 4 months old and the treatment dose ranged from 0.22 to 0.8 mg/kg ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

“…The youngest patient treated was 2 years and 4 months old and the treatment dose ranged from 0.22 to 0.8 mg/kg ( 11 ). Tolvaptan has been effectively used in 28 patients with hyponatremia and heart failure, but none of the patients were affected by SIADH ( 12 , 13 ). Its use in the pediatric age group in patients with hypervolemic hyponatremia due to congestive cardiac failure with restrictive cardiomyopathy and in patients with massive edema due to nephrotic syndrome have been reported ( 14 , 15 ).…”

Section: Discussionmentioning

confidence: 99%

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Tolvaptan Treatment in Children with Chronic Hyponatremia due to Inappropriate Antidiuretic Hormone Secretion: A Report of Three Cases

Tuli¹,

Tessaris²,

Einaudi³

et al. 2017

Jcrpe

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Hyponatremia is the most common electrolyte disorder among hospitalized patients and it is sometimes considered as a poor outcome predictor. Its correction is thus indicated, even in asymptomatic patients. The conventional treatment consists of fluid restriction in presence of euvolemia or hypervolemia; loop diuretics are used in some hypervolemic conditions such as cardiac heart failure, liver cirrhosis and nephrotic syndrome, while intravenous isotonic or hypertonic solutions are administered in hypovolemic conditions. The utilization of demeclocycline and urea is not indicated in pediatric ages due to lack of data on their toxicity and poor tolerance. Recently, a new therapeutic option has been developed, a class of non-peptide arginine vasopressin receptor antagonists called vaptans. Tolvaptan is the only such agent approved in Europe for the treatment of hyponatremia caused by syndrome of inappropriate antidiuretic hormone secretion (SIADH) in adults. In USA, tolvaptan and conivaptan have been approved for treatment of euvolemic and hypervolemic hyponatremia. Few data are so far available in paediatric patients, since only one trial has been registered in Europe which includes children and adolescents, but this trial is still ongoing. Here, we report three children with chronic hyponatremia due to SIADH in which tolvaptan has been used successfully.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tolvaptan Treatment in Children with Chronic Hyponatremia due to Inappropriate Antidiuretic Hormone Secretion: A Report of Three Cases

Tuli¹,

Tessaris²,

Einaudi³

et al. 2017

Jcrpe

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“…[5][6][7] En pacientes pediátricos respondedores, ha demostrado actuar aumentando el volumen urinario desde el primer día de tratamiento, controlando los síntomas congestivos con escasos efectos secundarios. 8,9 Si bien, hasta la fecha, este fármaco no ha demostrado una reducción de la mortalidad ni de los reingresos en pacientes con sodio < 135 mEq/L 2 , un subestudio de la eficacia de los antagonistas de la vasopresina en la insuficiencia cardiaca (EVEREST, efficacy of vasopressin antagonism in heart failure) demostró que el tolvaptán era beneficioso en términos de mortalidad y rehospitalizaciones en pacientes con sodio < 130 mEq/L. Actualmente, las únicas indicaciones de este fármaco aprobadas por la Agencia Europea de Medicamentos (EMEA) son la poliquistosis renal autosómica dominante y el síndrome de secreción inadecuada de hormona antidiurética (SIHAD) con hiponatremia.…”

Section: Comentariosunclassified

“…Los principales efectos secundarios descritos son los desbalances electrolíticos y el riesgo de deshidratación, presente en hasta el 20% de los casos en algunas series. 8 A pesar de que las dosis no están bien establecidas en pediatría, se ha utilizado en un rango de 0,1-0,75 mg/kg/día, repartidos en 1-2 veces. [8][9][10][11] El tolvaptán ha sido un fármaco seguro en nuestro caso, pues permitió reducir la dosis de otros diuréticos, mejorar la clase funcional y dar de alta a una paciente que dependía previamente de diuréticos intravenosos.…”

Section: Comentariosunclassified

Tolvaptán en un caso de síndrome cardiorrenal pediátrico. ¿Cuál es su papel?

Hernández

Martínez

Marín

et al. 2018

Arch Argent Pediatr

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The cardiorenal syndrome has been defined as a situation in which therapy to relieve congestive symptoms of heart failure is limited by a decreased renal function. The resistance to conventional diuretic treatment makes difficult managing these patients. Tolvaptan, a selective vasopressin-2 receptor antagonist, has been used successfully in adults with this pathology but the experience with children is very limited. A five-year-old girl with renal failure waiting for a heart transplant is presented. Tolvaptan (0.1 mg/kg/day) was started at very low dosage, resulting in an excellent response. We analyzed the creatinine, urea, urine volume and sodium evolution. Renal function also improved. She could be discharged after four days of treatment (156 days of hospitalization) with ambulatory favourable follow-up until heart transplant. Tolvaptan should be considered in pediatric cases of conventional diuretic-resistant congestive heart failure, especially when complicated by kidney disease.

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“…There are rare case reports about tolvaptan therapy for SIADH in childhood (3,5,6,13). Likewise, there is scarce data with tolvaptan therapy used to treat hypervolemic hyponatremia such as in cardiac failure and nephrotic syndrome in children (14)(15)(16)(17). Tolvaptan treatment has been used successfully for 3 children with SIADH (ROHHAD syndrome, large sellar-suprasellar tumor and surgery of astrocytoma, respectively) (5), for a patient with intracranial lymphoma (3), and a child with nephrotic syndrome (17).…”

Section: Introductionmentioning

confidence: 99%

Efficiency of Single Dose of Tolvaptan Treatment During the Triphasic Episode After Surgery for Craniopharyngioma

Gürbüz¹,

Taştan²,

Turan³

et al. 2018

Jcrpe

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What is already known on this topic? Hyponatremia is caused by the combination of excess ADH-induced water retention and secondary solute loss in patients with inappropriate antidiuretic hormone syndrome. Vaptans, arginine-vasopressin receptor antagonists are alternatively used for SIADH in adults. In children, vaptan treatment has not been approved for SIADH. What this study adds? Here, we report a successful tolvaptan treatment in a child with SIADH. Furthermore, we report that only one dose of tolvaptan in triphasic episode is sufficient efficiency. This data is the first child patient from Turkey.

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Efficacy and safety of tolvaptan for pediatric patients with congestive heart failure. Multicenter survey in the working group of the Japanese Society of PEdiatric Circulation and Hemodynamics (J-SPECH)

Cited by 29 publications

References 14 publications

Tolvaptan Treatment in Children with Chronic Hyponatremia due to Inappropriate Antidiuretic Hormone Secretion: A Report of Three Cases

Tolvaptan Treatment in Children with Chronic Hyponatremia due to Inappropriate Antidiuretic Hormone Secretion: A Report of Three Cases

Tolvaptán en un caso de síndrome cardiorrenal pediátrico. ¿Cuál es su papel?

Efficiency of Single Dose of Tolvaptan Treatment During the Triphasic Episode After Surgery for Craniopharyngioma

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