Durable response without recurrence to Tolvaptan improves long-term survival

Nakai, Masato; Suda, Goki; Kubo, Akinori; Tokuchi, Yoshimasa; Kitagataya, Takashi; Yamada, Ryoichi; Shigesawa, Taku; Suzuki, Kazuharu; Nakamura, Akihisa; Kawagishi, Naoki; Ohara, Masatsugu; Umemura, Machiko; Sho, Takuya; Morikawa, Kenichi; Ogawa, Koji; Sakamoto, Naoya

doi:10.1007/s00535-020-01721-8

Cited by 5 publications

(4 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, when a patient has a BW increase after 1 week of treatment and is therefore a possible non‐responder, SVEP1 SNP (rs2991364) should be measured. For patients without an SVEP1 SNP risk allele, measures should be employed to improve renal blood flow by reducing diuretics or performing large volume puncture with consideration of the late tolvaptan response 22 . For patients with a risk allele, the prediction score should be determined.…”

Section: Discussionmentioning

confidence: 99%

A genome‐wide association study identifying SVEP1 variant as a predictor of response to tolvaptan for cirrhotic ascites

Kawaratani

Sawai

Onishi

et al. 2021

Liver International

View full text Add to dashboard Cite

Background and Aims: Tolvaptan, an orally active vasopressin V2-receptor antagonist, has been used for patients with di cult-to-treat ascites in Japan. In this study, we conducted a genome-wide association study (GWAS) in the Japanese population to identify genetic variants associated with tolvaptan's e cacy for patients with hepatic ascites. Methods: From 2014 through 2018, genomic DNA samples were obtained from 550 patients who were treated with tolvaptan. Of those, 80 cases (non-responder; increase of body weight [BW]) and 333 controls (responder; > 1.5 kg decrease of BW) were included in the GWAS and replication study. Results: GWAS showed 5 candidate SNPs around the miR818, KIAA1109, and SVEP1 genes. After validation and performing a replication study, an SNP (rs2991364) located in the SVEP1 gene was found to have a signi cant genome-wide association (OR = 3.55, P = 2.01 x 10 − 8 ). Univariate and multivariate analyses showed that blood urea nitrogen (BUN) and SVEP1 SNP were signi cantly associated with the response (OR = 1.03, p = 0.02 and OR = 4.24, p < 0.0001, respectively). Based on a prediction model of logistic regression analysis in a population with the rs2991364 risk allele, the failure probability (= exp (score: 22.234 + BUN*0.077 + Na*-0.179) (1 + exp (score)) was determined for the detection of nonresponders. Assuming a cutoff of failure probability at 38.6%, sensitivity was 84.4%, speci city was 70% and AUC was 0.774. Conclusion: SVEP1 rs2991364 was identi ed as the speci c SNP for the tolvaptan response. The prediction score can identify tolvaptan non-responders and help to avoid a lengthy period of futile treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

A genome‐wide association study identifying SVEP1 variant as a predictor of response to tolvaptan for cirrhotic ascites

Kawaratani

Sawai

Onishi

et al. 2021

Liver International

View full text Add to dashboard Cite

show abstract

“…14 Furthermore, it is expected to improve QOL and the survival rate of cirrhosis. 15 Predictors of prognosis in cases of cirrhosis are a short-term response to tolvaptan and a low dosage of a conventional diuretic. 16 However, it is not possible to conduct a comparative study with a group that is not given tolvaptan, and there have been other advances in the treatment of liver cirrhosis, including nutritional therapy, so it is necessary to observe long-term improvement in prognosis.…”

Section: Algorithm Of Ascites Management For Liver Cirrhosis Inmentioning

confidence: 99%

“…Tolvaptan increases the serum level of albumin, decreases the ammonia level, and preserves renal function after 1 year of treatment 14 . Furthermore, it is expected to improve QOL and the survival rate of cirrhosis 15 . Predictors of prognosis in cases of cirrhosis are a short‐term response to tolvaptan and a low dosage of a conventional diuretic 16 .…”

mentioning

confidence: 99%

Algorithm of ascites management for liver cirrhosis in the tolvaptan era: Paradigm shift treatment improves the outcomes of cirrhotic patients?

Kogiso

2023

Hepatology Research

View full text Add to dashboard Cite

“…The development of liver cirrhosis (LC) in patients with chronic liver disease leads to a poor prognosis. 1 As several novel interventional treatment methods have recently been developed for LC, [1][2][3][4] predicting the prognosis of patients with LC and applying the right treatment modality are critical clinical issues. The Child-Pugh score and Model for End-Stage Liver Disease (MELD) score are usually utilized for predicting the prognosis of patients with LC.…”

Section: Introductionmentioning

confidence: 99%

Overestimated renal function in patients with liver cirrhosis predicts poor prognosis

Yoshida

Suda

Ohara

et al. 2022

Hepatology Research

Self Cite

View full text Add to dashboard Cite

Aim: A high prevalence of overestimated renal function in patients with liver cirrhosis (LC) has been reported; nonetheless, its impact on prognosis remains unclear. We aimed to evaluate the impact of overestimated renal function on prognosis in patients with LC.Methods: An overestimated renal function was defined as a >20% increase in the creatinine-based estimated glomerular filtration rate (eGFR), compared with cystatin C-based eGFR. LC patients with conserved serum, who were evaluated for muscle atrophy and had proper clinical information were included, and their prognostic factors were analyzed.Results: A total of 215 consecutive patients with LC were included. The prevalence of overestimated renal function was 29.8% (64/215). Kaplan-Meier survival analysis revealed that patients with overestimated renal function had a poorer prognosis than those without overestimated renal function (hazard ratio [HR]: 2.217 95% confidence interval [CI]: 1.290-3.810; p = 0.001). Subgroup analysis showed that overestimated renal function was a significant prognostic factor, irrespective of sex and the presence of hepatocellular carcinoma (HCC). Multivariate Cox regression analyses revealed that overestimated renal function was a significant and independent factor predictive of poor prognosis in the entire cohort (HR: 2.050; 95%

show abstract

Durable response without recurrence to Tolvaptan improves long-term survival

Cited by 5 publications

References 42 publications

A genome‐wide association study identifying SVEP1 variant as a predictor of response to tolvaptan for cirrhotic ascites

A genome‐wide association study identifying SVEP1 variant as a predictor of response to tolvaptan for cirrhotic ascites

Algorithm of ascites management for liver cirrhosis in the tolvaptan era: Paradigm shift treatment improves the outcomes of cirrhotic patients?

Overestimated renal function in patients with liver cirrhosis predicts poor prognosis

Contact Info

Product

Resources

About