Review of the REPRISE Trial: Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease

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Review of the REPRISE Trial: Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease

Journal Title: Nephrology – Open Journal - Year 2018, Vol 4, Issue 1

Abstract

In the past, Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease (ADPKD) and its Outcomes (TEMPO) trial showed Tolvaptan, a vasopressin V2-receptor antagonist, slowed the decline in the estimated Glomerular Filtration Rate (eGFR) in patients with estimated creatinine clearance of ≥60 ml per minute. With this in consideration, Replicating Evidence of Preserved Renal Function: Investigation of Tolvaptan Safety and Efficacy (REPRISE) trial was conducted to assess the efficacy and safety of Tolvaptan in patients with later stage ADPKD. In this trial, 1370 patients with later-stage ADPKD were randomized. These patients were either 18 to 55-years-old with eGFR of 25 to 65 mL per minute per 1.73 m2 of body surface area or 56 to 65-years-old with eGFR of 25 to 44 mL per minute per 1.73 m2 . The primary end-point of this trial was the change in eGFR between baseline and end of trial period, with adjustments made for exact duration that each patient participated for, interpolated to 1 year. The change from baseline that was noted in the Tolvaptan group was -2.34 mL per minute per 1.73 m2 vs. -3.61 mL per minute per 1.73 m2 in the placebo group. A difference of 1.27 mL per minute per 1.73 m2 (95% CI, p less than 0.001) was noted. Based on the data collected by the REPRISE trial over a 1-year period, it can be concluded that Tolvaptan slows the decline in eGFR than placebo in patients with later stage ADPKD.

Authors and Affiliations

Soroush Nomigolzar, Himax Patel

Keywords

: Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and its Outcomes. ADPKD. REPRISE. TEMPO. Autosomal dominant polycystic kidney disease; Tolvaptan. Vasopressin V2-receptor antagonist

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EP ID EP558760
DOI 10.17140/NPOJ-4-119
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