This report of vaptan
use, together with future cases, will increase the clinical evidence base in order for the FDA and EMA to decide the licensing status of this type of therapy.
announced that the Food and Drug Administration has approved Jynarque (tol vaptan
) as the first drug treatment to slow kidney function decline in adults at risk of rapidly progressing autosomal dominant polycystic kidney disease (ADPKD).
Management options for HN include discontinuation of diuretics, fluid restriction (FR), and administration of isotonic saline (NS), hypertonic saline (HS), or a vasopressin-receptor antagonist (or "vaptan
Nevertheless, "since there is inevitable decongestion with a vaptan
as a consequence of the free water excretion, one does, of course, 'treat' the [heart failure] to some extent." Clinical trials are underway to determine whether conivaptan improves outcomes in conditions other than hyponatremia.
However, treatment with vaptan
in paediatric age groups has not been licensed yet neither in Europe nor in the USA.
, a new group of drugs that blocks the AVP receptors, were recommended for the treatment of diseases accompanied by water retention .
 There have been several recent advances in the last year with revision in the guidelines for treatment and availability of vaptans
. Judicious use of vaptans
may help in treatment of hyponatremia.
The main modality of management in SIADH is water restriction, although in severe symptomatic cases hypertonic saline (3%) and drugs such as loop diuretics (furosemide), demeclocycline, and vaptans
should be used .
Alternative treatment options with loop diuretics, administration of oral urea, or vasopressin receptor antagonists (vaptans
) are discussed controversially in the literature [4, 6, 7].
Studies are being carried out internationally to see the role of VAPTANS
, vasopressin receptor antagonists in the treatment of hyponatremia and their effect on prevention of liver cirrhosis related complications8.
First proven efficacious in adults with autosomal dominant polycystic kidney disease, therapy with vaptans
holds promise also for the recessive form of the disease, which presents as, and often progresses to, ESRD during childhood.
A safer strategy may be represented by the administration of a new class of drugs, the vasopressin antagonists or vaptans
, which are capable of correcting hyponatremia in different clinical conditions, although data on major clinical outcomes are still conflicting and somewhat lacking .