IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0184380.html
   My bibliography  Save this article

Effects and safety of oral tolvaptan in patients with congestive heart failure: A systematic review and network meta-analysis

Author

Listed:
  • Mei-Yi Wu
  • Tzu-Ting Chen
  • Ying-Chun Chen
  • Der-Cherng Tarng
  • Yun-Chun Wu
  • Hsien-Ho Lin
  • Yu-Kang Tu

Abstract

Aims: Several studies reported treatment benefits of tolvaptan in patients with congestive heart failure (CHF). However, the optimal dosage remains unclear. We aimed to compare different dosage of tolvaptan to determine the optimal dosage in terms of the efficacy and safety. Methods: We searched MEDLINE, PubMed, EMBASE, Cochrane CENTRAL and ClinicalTrials.gov through Aug 31, 2016. Randomized controlled trials (RCTs) comparing tolvaptan of different dosages or to placebo in patients with CHF were included. We used network meta-analysis to look for the optimal dosage in terms of effectiveness and safety. Urine output, body weight change and change in serum sodium were the main outcomes of efficacy. Adverse effects were the secondary outcomes. Quality was assessed by Cochrane risk-of-bias tool. Results: Twelve RCTs reporting 14 articles with 5793 patients (mean age, 65.7 ± 11.9 years; 73.7% man) were included. Compared with placebo, the tolvaptan 30 mg had similar effects to tolvaptan 45–90 mg in terms of urine output (mean difference [MD] 2.03 liter; 95% confidence interval [CI] 1.3 to 2.71), body weight change (MD -1.12 kg; 95% CI -1.37 to -0.88) and change in serum sodium (MD 3.06 meq/L; 95% CI 2.43 to 3.68). Compared with placebo, tolvaptan of different dosage showed a non-significant higher risk of adverse effects. Conclusions: These findings suggest that tolvaptan 30 mg and 45 mg may be the optimum dosage for CHF patients, because of its ability to provide favourable clinical results without greater adverse effects. However, tolvaptan is not beneficial for reducing all-cause mortality in CHF patients.

Suggested Citation

  • Mei-Yi Wu & Tzu-Ting Chen & Ying-Chun Chen & Der-Cherng Tarng & Yun-Chun Wu & Hsien-Ho Lin & Yu-Kang Tu, 2017. "Effects and safety of oral tolvaptan in patients with congestive heart failure: A systematic review and network meta-analysis," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-15, September.
  • Handle: RePEc:plo:pone00:0184380
    DOI: 10.1371/journal.pone.0184380
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184380
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0184380&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0184380?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Sofia Dias & Nicky J. Welton & Alex J. Sutton & A. E. Ades, 2013. "Evidence Synthesis for Decision Making 5," Medical Decision Making, , vol. 33(5), pages 657-670, July.
    2. Sofia Dias & Nicky J. Welton & Alex J. Sutton & Deborah M. Caldwell & Guobing Lu & A. E. Ades, 2013. "Evidence Synthesis for Decision Making 4," Medical Decision Making, , vol. 33(5), pages 641-656, July.
    3. Anna Chaimani & Julian P T Higgins & Dimitris Mavridis & Panagiota Spyridonos & Georgia Salanti, 2013. "Graphical Tools for Network Meta-Analysis in STATA," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-12, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Konstantinos Katsanos & Panagiotis Kitrou & Stavros Spiliopoulos & Ioannis Maroulis & Theodore Petsas & Dimitris Karnabatidis, 2017. "Comparative effectiveness of different transarterial embolization therapies alone or in combination with local ablative or adjuvant systemic treatments for unresectable hepatocellular carcinoma: A net," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-31, September.
    2. Stefanie Reken & Sibylle Sturtz & Corinna Kiefer & Yvonne-Beatrice Böhler & Beate Wieseler, 2016. "Assumptions of Mixed Treatment Comparisons in Health Technology Assessments - Challenges and Possible Steps for Practical Application," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-16, August.
    3. Laura M Sawyer & Kinga Malottki & Celia Sabry-Grant & Najeeda Yasmeen & Emily Wright & Anne Sohrt & Emma Borg & Richard B Warren, 2019. "Assessing the relative efficacy of interleukin-17 and interleukin-23 targeted treatments for moderate-to-severe plaque psoriasis: A systematic review and network meta-analysis of PASI response," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-31, August.
    4. Theodoros Papakonstantinou & Adriani Nikolakopoulou & Julian P. T. Higgins & Matthias Egger & Georgia Salanti, 2020. "CINeMA: Software for semiautomated assessment of the confidence in the results of network meta‐analysis," Campbell Systematic Reviews, John Wiley & Sons, vol. 16(1), March.
    5. Wei Ding & Yulin Tan & Yan Qian & Wenbo Xue & Yibo Wang & Peng Jiang & Xuezhong Xu, 2020. "First-line targ veted therapies of advanced hepatocellular carcinoma: A Bayesian network analysis of randomized controlled trials," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-19, March.
    6. Fei Wen & Hongheng Du & Liangliang Ding & Jinxi Hu & Zifeng Huang & Hua Huang & Kaikai Li & Yuxia Mo & Anyin Kuang, 2020. "Clinical efficacy and safety of drug interventions for primary and secondary prevention of osteoporotic fractures in postmenopausal women: Network meta-analysis followed by factor and cluster analysis," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-22, June.
    7. Jonathan Mosseri & Ludovic Trinquart & Rémy Nizard & Philippe Ravaud, 2016. "Meta-Analysis of a Complex Network of Non-Pharmacological Interventions: The Example of Femoral Neck Fracture," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-16, January.
    8. Jesse Elliott & Amy Johnston & Don Husereau & Shannon E Kelly & Caroline Eagles & Alice Charach & Shu-Ching Hsieh & Zemin Bai & Alomgir Hossain & Becky Skidmore & Eva Tsakonas & Dagmara Chojecki & Muh, 2020. "Pharmacologic treatment of attention deficit hyperactivity disorder in adults: A systematic review and network meta-analysis," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-35, October.
    9. Mohamed A. Hassan & Wenxi Liu & Daniel J. McDonough & Xiwen Su & Zan Gao, 2022. "Comparative Effectiveness of Physical Activity Intervention Programs on Motor Skills in Children and Adolescents: A Systematic Review and Network Meta-Analysis," IJERPH, MDPI, vol. 19(19), pages 1-12, September.
    10. Fernanda S Tonin & Helena H Borba & Antonio M Mendes & Astrid Wiens & Fernando Fernandez-Llimos & Roberto Pontarolo, 2019. "Description of network meta-analysis geometry: A metrics design study," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-14, February.
    11. Shannon M Sullivan & Doug Coyle & George Wells, 2014. "What Guidance Are Researchers Given on How to Present Network Meta-Analyses to End-Users such as Policymakers and Clinicians? A Systematic Review," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-18, December.
    12. Howard Thom & Frank Ender & Saisudha Samavedam & Caridad Perez Vivez & Subhajit Gupta & Mukesh Dhariwal & Jan de Haan & Derek O’Boyle, 2019. "Effect of AcrySof versus other intraocular lens properties on the risk of Nd:YAG capsulotomy after cataract surgery: A systematic literature review and network meta-analysis," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-15, August.
    13. EunJin Ahn & GeunJoo Choi & Hyun Kang & ChongWha Baek & YongHun Jung & YoungCheol Woo & SiRa Bang, 2018. "Supraglottic airway devices as a strategy for unassisted tracheal intubation: A network meta-analysis," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-16, November.
    14. Ajaree Rayanakorn & Hooi-Leng Ser & Priyia Pusparajah & Kok-Gan Chan & Bey Hing Goh & Tahir Mehmood Khan & Surasak Saokaew & Shaun Wen Huey Lee & Learn-Han Lee, 2020. "Comparative efficacy of antibiotic(s) alone or in combination of corticosteroids in adults with acute bacterial meningitis: A systematic review and network meta-analysis," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-17, May.
    15. Lukas Schwingshackl & Sofia Dias & Barbara Strasser & Georg Hoffmann, 2013. "Impact of Different Training Modalities on Anthropometric and Metabolic Characteristics in Overweight/Obese Subjects: A Systematic Review and Network Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-10, December.
    16. Dandan Li & Tiansheng Wang & Su Shen & Sheng Cheng & Junxian Yu & Yang Zhang & Chao Zhang & Huilin Tang, 2015. "Effects of Fluroquinolones in Newly Diagnosed, Sputum-Positive Tuberculosis Therapy: A Systematic Review and Network Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-14, December.
    17. Cho-Hao Lee & Po-Huang Chen & Chin Lin & Chieh-Yung Wang & Ching-Liang Ho, 2020. "A network meta-analysis of maintenance therapy in chronic lymphocytic leukemia," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-18, January.
    18. Pepijn Vemer & Maiwenn J Al & Mark Oppe & Maureen P M H Rutten-van Mölken, 2017. "Mix and match. A simulation study on the impact of mixed-treatment comparison methods on health-economic outcomes," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-20, February.
    19. Dong Hyuk Kang & Kang Su Cho & Won Sik Ham & Hyungmin Lee & Jong Kyou Kwon & Young Deuk Choi & Joo Yong Lee, 2016. "Comparison of High, Intermediate, and Low Frequency Shock Wave Lithotripsy for Urinary Tract Stone Disease: Systematic Review and Network Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-22, July.
    20. Amin Doosti-Irani & Mohammad Ali Mansournia & Abbas Rahimi-Foroushani & Peiman Haddad & Kourosh Holakouie-Naieni, 2017. "Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-18, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0184380. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.