Investigators and institutions participating in the Acute heart failure Volume Control Multicenter rAndomized (AVCMA) trial are listed in the Appendix.
Acute heart failure volume control multicenter randomized (AVCMA) trial: Comparison of tolvaptan and carperitide
Article first published online: 19 OCT 2013
© 2013 The Authors. The Journal of Clinical Pharmacology Published by Wiley Periodicals, Inc. on behalf of The American College of Clinical Pharmacology
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
The Journal of Clinical Pharmacology
Volume 53, Issue 12, pages 1277–1285, December 2013
How to Cite
Suzuki, S., Yoshihisa, A., Yamaki, T., Sugimoto, K., Kunii, H., Nakazato, K., Abe, Y., Saito, T., Ohwada, T., Suzuki, H., Saitoh, S.-i., Kubota, I., Takeishi, Y. and on behalf of the AVCMA investigators (2013), Acute heart failure volume control multicenter randomized (AVCMA) trial: Comparison of tolvaptan and carperitide. Journal of Clinical Pharma, 53: 1277–1285. doi: 10.1002/jcph.197
- Issue published online: 14 NOV 2013
- Article first published online: 19 OCT 2013
- Manuscript Accepted: 23 SEP 2013
- Manuscript Received: 25 APR 2013
- Japanese Heart Foundation. Grant Number: 12100026
- acute decompensated heart failure;
- volume control;
Acute decompensated heart failure (ADHF) is a common and highly morbid cardiovascular disorder. Diuresis is a major therapy for the reduction of congestive symptoms. However, most diuretics cause hyponatremia, which is a worsening factor of ADHF patients prognosis. The purpose of this study was to examine the efficacy and safety of tolvaptan, which is a selective vasopressin V2 receptor antagonist and produces water excretion without changes in sodium excretion, compared with carperitide.
Methods and Results
One hundred and nine hospitalized ADHF patients were enrolled and randomly assigned to tolvaptan or carperitide treatment groups. Subjective symptoms and plasma BNP level were similarly improved by treatment in both groups. Urine volume was significantly higher in the tolvaptan group (P < .05), but volume of water intake was also higher in the tolvaptan group (P < .05). Blood pressure was significantly lower in the carperitide group than in the tolvaptan group after treatment (P < .05). Less adverse events such as worsening heart failure and hypotension requiring drug discontinuation were observed in the tolvaptan group (P = .027). The average drug cost of tolvaptan was lower than that of carperitide (P < .001).
Tolvaptan might be a novel promising agent for ADHF in terms of efficacy and safety compared to carperitide.