Update on tolvaptan for the treatment of hyponatremia

Abstract

Tolvaptan is a member of a new class of drugs, called the vaptans, that antagonize receptors of the neurohormone arginine vasopressin. From a clinical perspective, tolvaptan has been shown to be efficacious in the treatment of hyponatremia, whether it is idiopathic or disease related, and it may have a more favorable benefit/risk profile than other treatment modalities. From an economic perspective, tolvaptan is an expensive drug for treating hyponatremia, but recent economic cost-offset models provide evidence that tolvaptan can be cost effective. The cost–effectiveness of tolvaptan is driven by reduced healthcare resource usage and hospitalization costs. More comparative research of tolvaptan versus other pharmacotherapies and analyses of patients treated with tolvaptan in the real world are needed to better determine the benefits of tolvaptan usage to patient outcome, and more accurately assess its value in the treatment of hyponatremia, an independent predictor of morbidity, mortality and cost.

Keywords::

• antidiuretic hormone
• arginine vasopressin
• AVP receptor antagonist tolvaptan
• cost-effectiveness
• heart failure
• hyponatremia
• syndrome of inappropriate antidiuretic hormone secretion
• vaptans

Financial & competing interests disclosure

JF Dasta and JR Chiong are consultants and have received honoraria from Otsuka America Pharmaceutical, Inc. R Christian, IB Cassidy and K Friend are employees of Otsuka America Pharmaceutical, Inc. M Lingohr-Smith and J Lin are employees of Novosys Health, which has received research funds from Otsuka America Pharmaceutical, Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.