Dual Vasopressin Receptor Antagonism to Improve Congestion in Patients With Acute Heart Failure: Design of the AVANTI Trial
| Autor: | Finn Gustafsson, Adriaan A. Voors, Gerald Staedtler, Pablo Colorado, Daniel Burkhoff, Faiez Zannad, Wilfried Dinh, James E. Udelson, Steven R. Goldsmith, Peter Kolkhof |
|---|---|
| Přispěvatelé: | Cardiovascular Centre (CVC) |
| Rok vydání: | 2021 |
| Předmět: |
Congestive heart failure
Receptors Vasopressin CONIVAPTAN vasopressin medicine.drug_class medicine.medical_treatment diuretic MULTICENTER Renal function 030204 cardiovascular system & hematology FUROSEMIDE Placebo DOUBLE-BLIND 03 medical and health sciences 0302 clinical medicine Sodium Potassium Chloride Symporter Inhibitors medicine Humans 030212 general & internal medicine Diuretics Blood urea nitrogen Heart Failure OUTCOMES business.industry ARGININE-VASOPRESSIN Weight change ORAL TOLVAPTAN medicine.disease HOSPITALIZATION Heart failure Anesthesia decongestion Diuretic Conivaptan Cardiology and Cardiovascular Medicine business Antidiuretic Hormone Receptor Antagonists SYSTEM Vasopressin Antagonists WEIGHT CHANGE medicine.drug |
| Zdroj: | JOURNAL OF CARDIAC FAILURE, 27(2), 233-241. Churchill Livingstone Goldsmith, S R, Burkhoff, D, Gustafsson, F, Voors, A, Zannad, F, Kolkhof, P, Staedtler, G, Colorado, P, Dinh, W & Udelson, J E 2021, ' Dual Vasopressin Receptor Antagonism to Improve Congestion in Patients With Acute Heart Failure : Design of the AVANTI Trial ', Journal of Cardiac Failure, vol. 27, no. 2, pp. 233-241 . https://doi.org/10.1016/j.cardfail.2020.10.007 |
| ISSN: | 1071-9164 |
| DOI: | 10.1016/j.cardfail.2020.10.007 |
| Popis: | BACKGROUND: Loop diuretics are the main treatment for patients with acute heart failure, but are associated with neurohormonal stimulation and worsening renal function and do not improve long-term outcomes. Antagonists to arginine vasopressin may provide an alternative strategy to avoid these effects. The AVANTI study will investigate the efficacy and safety of pecavaptan, a novel, balanced dual-acting V1a/V2 vasopressin antagonist, both as adjunctive therapy to loop diuretics after admission for acute heart failure, and later as monotherapy.METHODS AND RESULTS: AVANTI is a double-blind, randomized phase II study in 571 patients hospitalized with acute heart failure and signs of persistent congestion before discharge. In part A, patients will receive either pecavaptan 30 mg/d or placebo with standard of care for 30 days. In part B, eligible patients will continue treatment or receive pecavaptan or diuretics as monotherapy for another 30 days. The primary end points for part A are changes in body weight and serum creatinine; for part B, changes in body weight and blood urea nitrogen/creatinine ratio.CONCLUSIONS: This study will provide the first evidence that a balanced V1a/V2 antagonist may safely enhance decongestion, both as an adjunct to loop diuretics and as an alternative strategy.TRIAL REGISTRATION NUMBER: NCT03901729. |
| Databáze: | OpenAIRE |
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