A double-blind, randomized, placebo-controlled pilot trial of atorvastatin for nephrogenic diabetes insipidus in lithium users.

Autor: Fotso Soh J; Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.; Douglas Mental Health University Institute, Montreal, QC, Canada., Beaulieu S; Douglas Mental Health University Institute, Montreal, QC, Canada., Trepiccione F; Division of Nephrology, University of Naples, Naples, Italy., Linnaranta O; Douglas Mental Health University Institute, Montreal, QC, Canada., Torres-Platas G; Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada., Platt RW; Department of Epidemiology, Biostatistics and Occupational Health, McGill University Health Centre, Montreal, QC, Canada., Renaud S; Douglas Mental Health University Institute, Montreal, QC, Canada., Su CL; Department of Epidemiology, Biostatistics and Occupational Health, McGill University Health Centre, Montreal, QC, Canada., Mucsi I; Division of Nephrology, University Health Network, University of Toronto (UofT), Toronto, ON, Canada., D'Apolito L; Biogem S.c.a.r.l., Istituto di Ricerche Genetiche 'Gaetano Salvatore', Ariano Irpino, Italy., Mulsant BH; Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, ON, Canada., Levinson A; Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, ON, Canada., Saury S; Douglas Mental Health University Institute, Montreal, QC, Canada., Müller D; Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, ON, Canada., Schaffer A; Department of Psychiatry, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada., Dols A; Amsterdam UMC, Department of Psychiatry, GGZinGeest, Neuroscience, Amsterdam, The Netherlands., Low N; Department of Psychiatry, McGill University Health Centre, Montreal, QC, Canada., Cervantes P; Department of Psychiatry, McGill University Health Centre, Montreal, QC, Canada., Christensen BM; Department of Biomedicine, University of Aarhus, Aarhus, Denmark., Herrmann N; Department of Psychiatry, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada., Rajji T; Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, ON, Canada., Rej S; Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.; Douglas Mental Health University Institute, Montreal, QC, Canada.
Jazyk: angličtina
Zdroj: Bipolar disorders [Bipolar Disord] 2021 Feb; Vol. 23 (1), pp. 66-75. Date of Electronic Publication: 2020 Jul 16.
DOI: 10.1111/bdi.12973
Abstrakt: Objective: Lithium remains an important treatment for mood disorders but is associated with kidney disease. Nephrogenic diabetes insipidus (NDI) is associated with up to 3-fold risk of incident chronic kidney disease among lithium users. There are limited randomized controlled trials (RCT) for treatments of lithium-induced NDI, and existing therapies can be poorly tolerated. Therefore, novel treatments are needed for lithium-induced NDI.
Method: We conducted a 12-week double-blind pilot RCT to assess the feasibility and efficacy of 20 mg/d atorvastatin vs placebo in the treatment of NDI in chronic lithium users. Patients, recruited between September 2017 and October 2018, were aged 18 to 85, currently on a stable dose of lithium, and determined to have NDI.
Results: Urinary osmolality (UOsm) at 12 weeks adjusted for baseline was not statistically different between groups (+39.6 mOsm/kg [95% CI, -35.3, 114.5] in atorvastatin compared to placebo groups). Secondary outcomes of fluid intake and aquaporin-2 excretions at 12 weeks adjusted for baseline were -0.13 L [95% CI, -0.54, 0.28] and 98.68 [95% CI, -190.34, 387.70], respectively. A moderate effect size was observed for improvements in baseline UOsm by ≥100 mOsm/kg at 12 weeks in patients who received atorvastatin compared to placebo (38.45% (10/26) vs 22.58% (7/31); Cohen's d = 0.66).
Conclusion: Among lithium users with NDI, atorvastatin 20 mg/d did not significantly improve urinary osmolality compared to placebo over a 12-week period. Larger confirmatory trials with longer follow-up periods may help to further assess the effects of statins on NDI, especially within patients with more severe NDI.
(© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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