Title |
Recommendations for the use of tolvaptan in autosomal dominant polycystic kidney disease: a position statement on behalf of the ERA-EDTA Working Groups on Inherited Kidney Disorders and European Renal Best Practice
|
---|---|
Published in |
Nephrology Dialysis Transplantation, January 2016
|
DOI | 10.1093/ndt/gfv456 |
Pubmed ID | |
Authors |
Ron T. Gansevoort, Mustafa Arici, Thomas Benzing, Henrik Birn, Giovambattista Capasso, Adrian Covic, Olivier Devuyst, Christiane Drechsler, Kai-Uwe Eckardt, Francesco Emma, Bertrand Knebelmann, Yannick Le Meur, Ziad A. Massy, Albert C.M. Ong, Alberto Ortiz, Franz Schaefer, Roser Torra, Raymond Vanholder, Andrzej Więcek, Carmine Zoccali, Wim Van Biesen |
Abstract |
Recently, the European Medicines Agency approved the use of the vasopressin V2 receptor antagonist tolvaptan to slow the progression of cyst development and renal insufficiency of autosomal dominant polycystic kidney disease (ADPKD) in adult patients with chronic kidney disease stages 1-3 at initiation of treatment with evidence of rapidly progressing disease. In this paper, on behalf of the ERA-EDTA Working Groups of Inherited Kidney Disorders and European Renal Best Practice, we aim to provide guidance for making the decision as to which ADPKD patients to treat with tolvaptan. The present position statement includes a series of recommendations resulting in a hierarchical decision algorithm that encompasses a sequence of risk-factor assessments in a descending order of reliability. By examining the best-validated markers first, we aim to identify ADPKD patients who have documented rapid disease progression or are likely to have rapid disease progression. We believe that this procedure offers the best opportunity to select patients who are most likely to benefit from tolvaptan, thus improving the benefit-to-risk ratio and cost-effectiveness of this treatment. It is important to emphasize that the decision to initiate treatment requires the consideration of many factors besides eligibility, such as contraindications, potential adverse events, as well as patient motivation and lifestyle factors, and requires shared decision-making with the patient. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
India | 10 | 10% |
United Kingdom | 9 | 9% |
United States | 7 | 7% |
Turkey | 4 | 4% |
Canada | 3 | 3% |
France | 3 | 3% |
Ecuador | 3 | 3% |
Mexico | 3 | 3% |
Egypt | 2 | 2% |
Other | 15 | 15% |
Unknown | 40 | 40% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 68 | 69% |
Practitioners (doctors, other healthcare professionals) | 19 | 19% |
Scientists | 9 | 9% |
Science communicators (journalists, bloggers, editors) | 3 | 3% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Germany | 1 | <1% |
Italy | 1 | <1% |
Australia | 1 | <1% |
Brazil | 1 | <1% |
United Kingdom | 1 | <1% |
Japan | 1 | <1% |
Unknown | 247 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 35 | 14% |
Other | 28 | 11% |
Student > Ph. D. Student | 26 | 10% |
Student > Master | 25 | 10% |
Student > Doctoral Student | 18 | 7% |
Other | 62 | 25% |
Unknown | 59 | 23% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 122 | 48% |
Biochemistry, Genetics and Molecular Biology | 19 | 8% |
Nursing and Health Professions | 7 | 3% |
Agricultural and Biological Sciences | 7 | 3% |
Pharmacology, Toxicology and Pharmaceutical Science | 7 | 3% |
Other | 26 | 10% |
Unknown | 65 | 26% |