Cases with Refractory Ascites and a Delayed Response to Tolvaptan
نویسندگان
چکیده
The patient was a 67-year-old female with liver cirrhosis due to hepatitis C. She was administered furosemide at 20 mg/day and spironolactone at 25 mg/day, but the ascites did not improve. Despite the additional administration of tolvaptan at 3.75 mg/day, the response to ascites was still poor. While the dose of tolvaptan was thereafter increased to 7.5 mg/day on the 7th hospital day, the ascites still persisted. However, she continued to receive tolvaptan (7.5 mg/day) because the worsening of her subjective symptoms was mild and she wished to do so. The ascites was later found to have almost completely disappeared on computed tomography (CT) at 6 months.
منابع مشابه
Re-response to tolvaptan after furosemide dose reduction in a patient with refractory ascites
Tolvaptan is a new drug used for treating ascites induced by liver cirrhosis, and it is covered by health insurance in Japan. In the present report, we describe the case of a 74-year-old man with type C liver cirrhosis and refractory ascites. He was receiving furosemide and spironolactone daily, but still required repeat puncture for ascites removal. Administration of tolvaptan (3.75 mg/day) wa...
متن کاملNutritional status and long-term prognosis in patients with refractory hepatic ascites treated with tolvaptan
Objective: We evaluated whether nutritional status and long-term prognosis of patients with refractory hepatic ascites improved after treatment with tolvaptan. Methods: We retrospectively studied data for a total of 50 patients with hepatic ascites treated with tolvaptan from April 2011 to January 2016. Bloatedness was assessed by using the Japanese version of the support team assessment schedu...
متن کاملTolvaptan for the Treatment of Refractory Ascites
To the Editor: The findings from a Japanese phase 3 trial revealed that tolvaptan (Otsuka Pharmaceutical, Osaka, Japan), a non-peptide antagonist of the vasopressin type 2 receptor, is effective in the treatment of refractory ascites in cirrhotic patients. Although this agent is now widely used in clinical practice, few reports have so far been published regarding its real-world efficacy. The r...
متن کاملEffectiveness of tolvaptan monotherapy and low-dose furosemide/tolvaptan combination therapy for hepatoprotection and diuresis in a rat cirrhotic model
Spironolactone and furosemide, which are used to treat ascites associated with decompensated cirrhosis, are ineffective in treating refractory ascites. Hence, combination therapy with tolvaptan, a vasopressin V2 receptor antagonist, has been approved in Japan. Tolvaptan monotherapy and combination therapy with furosemide inhibit fibrosis in cardiac remodeling; hence, we examined these therapies...
متن کاملEfficacy of tolvaptan for the patients with advanced hepatocellular carcinoma
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 t...
متن کامل