Evidence map›Paper›PMID 19561338›Full record

Trial reportEuropean heart journal2009

Effects of tolvaptan on dyspnoea relief from the EVEREST trials.

Peter S Pang, Marvin A Konstam, Holly B Krasa, Karl Swedberg, Faiez Zannad, John E A Blair, Christopher Zimmer, John R Teerlink, Aldo P Maggioni, John C Burnett and 5 more

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02476409 (Tolvaptan Treatment to Reverse Worsening Outpatient Heart Failure), which is not on this map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
5.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02476409 phase4completednot on this mapstarted 2015, after this paper: background citation

Tolvaptan Treatment to Reverse Worsening Outpatient Heart Failure: Possible Role of Copeptin In Identifying Responders (TROUPER)

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2015 to 2021Enrolled40ConditionsCongestive Heart FailureArmstolvaptan, Placebo
3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Early treatment with tolvaptan improves diuretic response in acute heart failure with renal dysfunction.Clinical research in cardiology : official journal of the German Cardiac Society · 2017
    Trial
  6. Trial
  7. Trial
  8. Trial
  9. Article
  10. Review
  11. Review
  12. Article
  13. Article
  14. Review
  15. Review
  16. Continuous infusion of furosemide versus intermittent boluses in acute decompensated heart failure: Effect on thoracic fluid content.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2018
    Article
  17. Diuretic Treatment in Heart Failure.The New England journal of medicine · 2017
    Review
  18. Review
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 6 countries.

Peter S PangDepartment of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Marvin A Konstam
Holly B Krasa
Karl Swedberg
Faiez Zannad
John E A Blair
Christopher Zimmer
John R Teerlink
Aldo P Maggioni
John C Burnett
Liliana Grinfeld
John Ouyang
James E Udelson
Mihai Gheorghiade
Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) Investigators
Northwestern University · USOtsuka (Japan) · JPTufts University · USAssociazione Nazionale Medici Cardiologi Ospedalieri · ITCentre d’Investigation Clinique Innovation Technologique de Nancy · FRHospital Italiano de Buenos Aires · ARMayo Clinic · USUniversity of California, San Francisco · USUniversity of Gothenburg · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo describe the effects of tolvaptan therapy on dyspnoea relief based on timing of delivery, influence of concomitant therapies, and baseline patient and clinical characteristics. Also, the influence of clinical trial design on dyspnoea measurement, from the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) trials. METHODS AND

resultsPost hoc analysis was performed based on the endpoint of patient-assessed dyspnoea. Changes from baseline at inpatient Day 1 were compared between treatment groups by the van Elteren test. Pre-determined subgroup analyses were also performed. Tolvaptan's effects are greatest within 12 h after first dose with an additional, but modest dyspnoea improvement benefit irrespective of time after admission. Overall, patients continue to report dyspnoea improvement up to 60 h after admission. The window of enrolment, up to 48 h after admission, combined with measurement on 'Day 1' led to a wide range over when dyspnoea was assessed.

conclusionPost hoc analysis suggests that tolvaptan modestly improves dyspnoea compared with standard therapy alone, regardless if given early or relatively late after hospitalization, and also across major pre-specified subgroups, despite ongoing background therapy aimed at relieving signs and symptoms. Significant variability around when dyspnoea was assessed, in addition to the persistence of dyspnoea despite ongoing background therapy, may influence how future clinical trials assess dyspnoea in acute heart failure syndromes.

Indexed as

AgedBenzazepinesDouble-Blind MethodDyspneaFemaleHumansMalePulmonary AtelectasisRespiratory System AgentsTolvaptanTreatment OutcomeBenzazepinesRespiratory System AgentsTolvaptan

Identifiers

PMID19561338
PMCPMC2742783
OpenAlexW2014557512

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.