Tolvaptan in the Treatment of Syndrome of Inappropriate Anti-Diuretic Hormone in Cancer Patients
Birol Ocak1, Ahmet Bilgehan Sahin1, Bahar Dakiki2, Burcu Caner1, Hulya Ertas1, Sibel Oyucu Orhan1, Adem Deligönül1, Erdem Cubukcu1, Turkkan Evrensel11Departmant of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey, 2Department of Internal Medicine, Faculty of Medicine, Uludag University, Bursa, Turkey
Objectives: This study aimed to reveal the therapeutic efficacy and side effects of tolvaptan use in patients with hypotonic euvolemic hyponatremia caused by syndrome of inappropriate anti-diuretic hormone (SIADH) in our oncology clinic. Herein is presented the first real-life data on the use of tolvaptan in hyponatremia observed in cancer patients in Turkey to the researchers’ knowledge. Methods: Clinically euvolemic patients who had serum osmolality <275 mOsm/kg, urine osmolality >100 mOsm/kg, urine sodium concentration >40 mmol/L and were diagnosed with SIADH, were scanned via electronic data. In treatment, tolvaptan 15 mg/day was administered for 3 days. Results: Hypotonic euvolemic hyponatremia due to SIADH was diagnosed in 24 patients (16 males, 8 females) who followed up for malignancy. The median sodium value of the patients before tolvaptan treatment was 121.5 mEq/L. The median sodium concentrations in the 3 days of treatment were 126.0 mEq/L, 132.0 mEq/L and 137.0 mEq/L, respectively. In 6 patients, adverse effects were observed; none of them stopped or paused treatment, however. Only 2 patients were discharged, while the other patients died. Conclusion: The use of tolvaptan in the treatment of SIADH-induced hypotonic euvolemic hyponatremia provided an effective correction in serum sodium concentration, and improved the symptoms associated with hyponatremia. Keywords: Cancer patients, hypotonic euvolemic hyponatremia, syndrome of inappropriate anti-diuretic hormone, tolvaptan
Cite This Article
Ocak B, Sahin A, Dakiki B, Caner B, Ertas H, Oyucu Orhan S, Deligönül A, Cubukcu E, Evrensel T. Tolvaptan in the Treatment of Syndrome of Inappropriate Anti-Diuretic Hormone in Cancer Patients. EJMI. 2020; 4(4): 490-494
Corresponding Author: Birol Ocak