Syndrome Of Inappropriate Antidiuretic Hormone

Both Familiarity with and Use of Samsca and Vaprisol, Newer Agents to Treat ...

EXTON, Penn.--( BUSINESS WIRE )--While nephrologists are significantly more familiar with both Astellas’ Vaprisol (conivaptan) and Otsuka’s Samsca (tolvaptan) compared to emergency physicians, both groups are less familiar with these newer agents compared to most other therapies used to treat hyponatremia. While use varies by type and cause of hyponatremia, nephrologists report that a relatively small percent of the patients who receive a therapeutic intervention for hyponatremia receive either of these agents, and reported use is even lower among emergency physicians. Moreover, only about one-half of nephrologists and one-fifth to one-quarter of emergency physicians report any use of these agents. The main obstacles to increased use of Vaprisol and Samsca are lack of familiarity and formulary status. Lack of need is also a significant obstacle for just over one-third of physicians.

There are perceived differences between the products, with Samsca having a competitive advantage on a number of administration and company support related attributes, although these attributes tend to be less important compared to a number of other attributes when selecting a therapy to treat hyponatremia. Samsca also leads Vaprisol on representative contact rates. Nephrologists report the most common recent change in the management of hyponatremia is the increased use of vaptans, specifically Samsca, and both physician groups expect small but significant increases in the use of these products in the next six months.

Despite availability of newer agents, there remain a number of challenges and unmet needs in the management of hyponatremia. While familiarity with new agents in development including Sanofi’s satavaptan, Cardiokine’s lixivaptan, and Astellas’s oral conivaptan is low, nephrologists report a preference for non-peptide selective vasopressin V2 receptor antagonists over V1A/V2 receptor antagonists.

TreatmentTrends : Hyponatremia is a syndicated report, based on primary market research with 101 nephrologists and 50 emergency physicians, which provides a comprehensive view of the current and expected future management of hyponatremia in the United States. The report covers various types of hyponatremia (euvolemic, hypervolemic and hypovolemic) as well as causes (e.g. congestive heart failure, liver cirrhosis, Syndrome of Inappropriate Anti-Diuretic Hormone). TreatmentTrends: Hyponatremia covers the use of agents to treat hyponatremia, as well as attitudes and perceptions toward these agents, advantages and disadvantages, patient types, barriers to growth, company promotion and expected future use.

Syndrome of inappropriate antidiuretic hormone production (SIADH ...

A 74-year-old man with low ejection fraction systolic heart failure comes to the Emergency Department with shortness of breath. His past medical history is significant for small cell lung cancer and he is on metformin. On physical exam, the patient is found to have 2+ pitting edema in both lower extremities. The patient is started on furosemide. His metabolic panel is within normal limits with the exception of serum sodium of 128 mEq/L.

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