Dual Vasopressin Receptor Antagonism to Improve Congestion in Patients With Acute Heart Failure: Design of the AVANTI Trial

BackgroundLoop diuretics are the main treatment for patients with acute heart failure, but associated neurohormonal stimulation and worsening renal function do not improve long-term outcomes. Antagonists to arginine vasopressin may provide an alternative strategy avoid these effects. The AVANTI study will investigate efficacy safety of pecavaptan, a novel, balanced dual-acting V1a/V2 antagonist, both as adjunctive therapy loop after admission later monotherapy.Methods ResultsAVANTI is double-blind, randomized phase II in 571 hospitalized failure signs persistent congestion before discharge. In part A, receive either pecavaptan 30 mg/d or placebo standard care days. B, eligible continue monotherapy another primary end points A changes body weight serum creatinine; blood urea nitrogen/creatinine ratio.ConclusionsThis first evidence that antagonist safely enhance decongestion, adjunct strategy.Trial registration numberNCT03901729