World journal of gastroenterology · 2017
Efficacy of tolvaptan for the patients with advanced hepatocellular carcinoma.
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Miyazaki Masayuki, Yada Masayoshi, Tanaka Kosuke, Senjyu Takeshi, Goya Takeshi, Motomura Kenta, Kohjima Motoyuki, Kato Masaki, Masumoto Akihide, Kotoh Kazuhiro
Аннотация
AIM: To investigate the factors influenced the efficacy of tolvaptan (TLV) in liver cirrhosis.
METHODS: We retrospectively enrolled 61 consecutive patients with refractory hepatic ascites. All of them had been treated with furosemide and spironolactone before admission, and treated with TLV for 7 d in our hospital. The effect of TLV was defined by the rate of body weight loss, and the factors that influenced TLV efficacy were analyzed using multiple regression.
RESULTS: Coexistent hepatocellular carcinoma (HCC) was the only significant predictive variable that attenuated the efficacy of TLV. In stratified analysis, high doses of furosemide decreased the efficacy of TLV in patients with HCC, and increased efficacy in those without HCC. In the latter, a high Child-Pugh-Turcotte score had a positive influence and a high concentration of lactate dehydrogenase had a negative influence on the effectiveness of TLV.
CONCLUSION: Development of ascites may differ between patients with liver failure and those with HCC progression. A sufficient preceding dose of furosemide decreases diuretic effect of TLV.
METHODS: We retrospectively enrolled 61 consecutive patients with refractory hepatic ascites. All of them had been treated with furosemide and spironolactone before admission, and treated with TLV for 7 d in our hospital. The effect of TLV was defined by the rate of body weight loss, and the factors that influenced TLV efficacy were analyzed using multiple regression.
RESULTS: Coexistent hepatocellular carcinoma (HCC) was the only significant predictive variable that attenuated the efficacy of TLV. In stratified analysis, high doses of furosemide decreased the efficacy of TLV in patients with HCC, and increased efficacy in those without HCC. In the latter, a high Child-Pugh-Turcotte score had a positive influence and a high concentration of lactate dehydrogenase had a negative influence on the effectiveness of TLV.
CONCLUSION: Development of ascites may differ between patients with liver failure and those with HCC progression. A sufficient preceding dose of furosemide decreases diuretic effect of TLV.
Предметные рубрики MeSH
AgedAged, 80 and overAntidiuretic Hormone Receptor AntagonistsAscitesBenzazepinesBody WeightCarcinoma, HepatocellularDisease ProgressionDiureticsDose-Response Relationship, DrugDrug InteractionsDrug ResistanceDrug Therapy, CombinationFemaleFurosemideHumansLiverLiver FailureLiver NeoplasmsMaleMiddle AgedNeoplasm StagingRetrospective StudiesSpironolactoneTolvaptanTreatment Outcome