Cost-effectiveness of tolvaptan for the treatment of hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion in Sweden

Jamookeeah, Clare; Robinson, Paul; O'Reilly, K.; Lundberg, Johan; Gisby, M.; Ländin, M.; Skov, Jakob; Trueman, David

doi:10.1186/s12902-016-0104-z

Cited by 19 publications

(17 citation statements)

References 32 publications

(43 reference statements)

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“…These studies reported effective correction of hyponatremia and improvement of performance status, without any serious adverse events. However, according to our systematic search, in lung cancer patients, the effect of V2R antagonist treatment on mortality has only been evaluated in one study, which also demonstrated the cost-effectiveness of tolvaptan treatment in Swedish patients with SIADH in pneumonia or SCLC [72].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Prognostic Significance of Hyponatremia in Lung Cancer Patients: Systematic Review and Meta-Analysis

Bartalis¹,

Gergics²,

Tinusz³

et al. 2020

Preprint

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Background The prevalence of hyponatremia is highly variable among lung cancer patients. It is also an important predictive factor, according to numerous studies. However, its prevalence and prognostic significance in subgroups of lung cancer patients, e.g. in small cell and non-small cell lung cancers (SCLC and NSCLC, respectively), have not yet been evaluated in a meta-analysis.Methods We report this systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2009) Statement. We have registered our meta-analysis and review’s protocol to the PROSPERO International Prospective Register of Systematic Reviews, with the following registration number: CRD42020167013. A systematic search was done in the following sources: MEDLINE, Embase, CENTRAL, Web of Science, ClinicalTrials.gov, a WHO Global Health Library. We extracted the effect measure for each outcome as the relative risk (RR) with the related 95% confidence interval (CI). Results We identified a total of 8127 potentially eligible studies and we included 25 studies in our evaluation. The prevalence of hyponatremia in lung cancer patients varied between 3% and 56.1% with an average of 23% without any significant differences between the following subgroups: cancer type (p=0.780), gender (p=0.223), age (p=0.773), ECOG state (p=0.317) and the extent of disease (p=0.999). Hyponatremia was more consistently an independent prognostic factor in NSCLC than in SCLC. The overall survival (OS) was significantly lower in hyponatremic compared to normonatremic patients at 10 months (RR: 0.59, 95% CI, 0.47 to 0.74, p<0.001) and at 20 months (RR: 0.44, 95% CI, 0.33 to 0.59, p<0.001), with worse survival rates in NSCLC than in SCLC (27% vs 42%) (p<0.001). If hyponatremia was corrected, OS at 10 months was 1.83 times higher than in the uncorrected hyponatremia group (95% CI, 1.37 to 2.44, p<0.001), but at 20 months no statistically significant difference could be found between these subgroups (p=0.067).Conclusions Low serum sodium levels have a negative impact on mortality at 10 and 20 months, which is more pronounced among NSCLC patients. The correction of hyponatremia has a positive effect on OS rates at 10 months, but this advantage disappears by 20 months.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Prognostic Significance of Hyponatremia in Lung Cancer Patients: Systematic Review and Meta-Analysis

Bartalis¹,

Gergics²,

Tinusz³

et al. 2020

Preprint

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“…UADHS gelişmiş KHAK vakalarında, tedavi sonrası serum sodyum takibi rekürrensi saptamada kullanılabilmektedir. Tolvaptan vazopressin V2 antagonistidir (75) . Yalnızca oral olarak kullanılır ve günlük doz 15 mg'dır.…”

Section: Tanıunclassified

Emergencies in Lung Cancer

Gümüş¹,

Özyurt²

2018

GGHS

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İnsanlarda beklenen ortalama yaşam süresinin artmasıyla birlikte kanser vakalarında da artışlar görülmektedir. Özellikle akciğer kanserinin görülme sıklığı ve mortalitesi dünya çapında artmaya devam etmektedir. Bu hastalarda sıklıkla akut ciddi semptomlar ve yaşamı tehdit eden durumlar ortaya çıkmakta ve acil tıbbi bakım gerekmektedir. Akciğer kanserinde acil servise başvuru ve mortalite diğer solit tümörlerden daha fazla görülmektedir. Bu acil durumlar kanserle direkt veya dolaylı olarak ya da tümörün tedavisi ile ortaya çıkar ve potansiyel olarak yaşamı tehdit eder. Tümörün bölgesel yayılımı ilişkili olarak vena kava süperior sendromu, perikardiyal tamponat, masif hemoptizi, massif plevral efüzyon ve akut hava yolu obstrüksiyonu görülmektedir. Hiperkalsemi, hiponatremi, uygunsuz ADH salınımı sendromu ve tümör lizis sendromu ise akciğer kanserinde ortaya çıkan metabolik acil durumlardır. Beyin metastazları, kemik metastazları ve spinal kord basısı uzak metastazlara bağlı olarak ortaya çıkmaktadır. Ayrıca, bu hastalarda kemoterapiye bağlı olarak febril nötropeni, hipersensitivite reaksiyonları ve anaflaksi, radyoterapiye bağlı olarak akut radyasyon pnömonitisi ve özefajit ortaya çıkmaktadır. Onkolojik aciller hayatı tehtit eder ve mortalitesi yüksektir. Mortalite ve morbiditeyi azaltmak için erken tanı ve tedavi büyük önem taşır. Çünkü tanı ve tedavide gecikmeler çoğu zaman ölümle sonuçlanabilmektedir.

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“…Jamookeeah et al ( 65 ) performed a cost-utility analysis using a discrete event simulation to model the progression of patients with hyponatremia due to SIADH who have failed fluid restriction (or were not suitable to fluid restriction) and were therefore treated with tolvaptan or no active treatment through inpatient admissions over a 30-day period in Sweden. Tolvaptan use was associated with reduced costs and increased quality-adjusted life years compared with no active treatment strategy.…”

Section: Remaining Uncertainties About the Use Of Vras In Hyponatremimentioning

confidence: 99%

Vasopressin Receptor Antagonists in Hyponatremia: Uses and Misuses

Rondon‐Berrios

Berl

2017

Front. Med.

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Decreases in the concentration of sodium in plasma constitute hyponatremia, the commonest electrolyte disorder in clinical medicine. It is now well established that its presence conveys an increased mortality risk even when the decrement is mild. In addition, recent evidence suggests that chronic and apparently asymptomatic hyponatremia is associated with increased morbidity including neurocognitive deficits and bone fractures. Furthermore, hyponatremia is associated with higher health care-related expenses. Consequently, exploring new therapeutic strategies that increase plasma sodium in a safe and effective manner is of paramount importance. In this regard, there are scant data to support the use of traditional management strategies for hyponatremia (fluid restriction, salt tablets, loop diuretics, and normal saline). Furthermore, data from a large hyponatremia registry reveal the limited efficacy of these therapies. More recently vasopressin receptor antagonists provide a promising treatment for hyponatremia by targeting its most common mechanism, namely, increased vasopressin activity. However, uncertainty still lingers as to the optimal indications for the use of vasopressin receptor antagonists in hyponatremia and a few reports have described complications resulting from their misuse. This review summarizes the appropriate and inappropriate uses of vasopressin receptor antagonists in the treatment of hyponatremia.

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Cost-effectiveness of tolvaptan for the treatment of hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion in Sweden

Cited by 19 publications

References 32 publications

Prevalence and Prognostic Significance of Hyponatremia in Lung Cancer Patients: Systematic Review and Meta-Analysis

Prevalence and Prognostic Significance of Hyponatremia in Lung Cancer Patients: Systematic Review and Meta-Analysis

Emergencies in Lung Cancer

Vasopressin Receptor Antagonists in Hyponatremia: Uses and Misuses

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