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Medication for heart failure may be helpful addition to standard therapies

Results from a clinical trial indicate that the medication tolvaptan may be a promising addition to standard therapy for treating patients hospitalized for heart failure, according to a study in the April 28 issue of The Journal of the American Medical Association (JAMA).

Hospitalizations for heart failure are common in the United States, with 995,000 hospital discharges for heart failure in 2001, according to background information in the article. Pharmacological management of systemic congestion in heart failure (buildup of excess fluid in the lungs and some other body tissues) is often inadequate; the 6-month postdischarge readmission rates are as high as 50 percent. Although diuretics are the mainstay therapy for congestion, their use has been associated with hypotension (abnormally low blood pressure), electrolyte abnormalities and worsening kidney function. The medication tolvaptan is thought to help treat heart failure without adversely affecting electrolytes and kidney function.

Mihai Gheorghiade, M.D., of Northwestern University Feinberg School of Medicine, Chicago, and investigators with the Acute and Chronic Therapeutic Impact of a Vasopressin Antagonist in Congestive Heart Failure (ACTIV in CHF) trial evaluated the clinical effects of tolvaptan in patients hospitalized for heart failure. This randomized, double blind, placebo-controlled trial was conducted at 45 centers in the United States and Argentina, and enrolled 319 patients who were hospitalized for heart failure and who had persistent signs and symptoms of systemic congestion despite standard therapy.

After admission, patients were randomized to receive 30, 60, or 90 mg of oral tolvaptan or placebo in addition to standard therapy, including diuretics. The study drug was continued for up to 60 days.

The researchers found that "tolvaptan in addition to standard therapy including diuretics increased net fluid loss resulting in decreased body weight more effectively
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Contact: Elizabeth Crown
312-503-8928
JAMA and Archives Journals
27-Apr-2004


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