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Abstract: FR-PO291

Safety and Efficacy of Tolvaptan in Lung Cancer with Hyponatremia Due to the Syndrome of Inappropriate Antidiuretics Hormone

Session Information

Category: Fluid and Electrolytes

  • 902 Fluid and Electrolytes: Clinical

Authors

  • Cho, Hyun Seop, Gyeongsang national university hospital, Jinju, Gyeongsangnam-do, Korea (the Republic of)
  • Kwak, Ji-Hye, Gyeongsang national university hospital, Jinju, Gyeongsangnam-do, Korea (the Republic of)
  • Jang, Ha nee, Gyeongsang national university hospital, Jinju, Gyeongsangnam-do, Korea (the Republic of)
  • Lee, Tae won, Gyeongsang National University Changwon Hospital, Changwon, Gyeonsangnam-do, Korea (the Republic of)
  • Park, Dong Jun, Gyeongsang National University Changwon Hospital, Changwon, Gyeonsangnam-do, Korea (the Republic of)
  • Chang, Se-Ho, Gyeongsang national university hospital, Jinju, Gyeongsangnam-do, Korea (the Republic of)
Background

Hyponatremia is the most common electrolyte disorder in lung cancer patients and has been associated with poor prognosis. We investigated the safety and efficacy of tolvaptan in lung cancer with the syndrome of inappropriate antidiuretics hormone(SIADH).

Methods

We reviewed medical record database for all lung cancer patients with SIADH treated with tolvaptan. All patients received 7.5mg/day as an initial dose. Overcorrection of serum sodium was defined as an increased of serum sodium exceeding 12 mmol/L over 24 hours or 8 mmol/L over 8 hours.

Results

41 patients (32 male patients, aged 67.61 ± 10.1 years) with lung cancer treated with tolvaptan were enrolled. Serum sodium increased significantly from baseline during the first 24 hours (122.68 ± 4.54 vs 132.05 ± 4.27 mmol/L, p=0.03), and then plateaued until day 14(134.27 ± 6.11 mmol/L). There was no difference in baseline sodium level according to a type of lung cancer(121.97 ± 3.47 vs 123.68 ± 5.26 mmol/L, p=0.223). In small cell lung cancer, the change was significantly higher (11.09 ± 2.83 mmol/L) than in non-small cell lung cancer (7.36 ± 6.07 mmol/L, P= 0.029). But, there was no difference in the rate of correction between severe hyponatremia(<125 mmol/L) and moderate hyponatremia (p=0.48). Also, there was no difference in the rate of correction according to BMI (p=0.057). No serious adverse events were reported, but in 36.6 % of patient hyponatremia was overcorrected and in 14.6% of patients a slight increase in liver function test was observed.

Conclusion

In patients with lung cancer patient with SIADH, initial dose 7.5 mg tolvaptan was well-tolerated, relatively safe and effective.