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    Por favor, use este identificador para citar o enlazar este ítem:https://uvadoc.uva.es/handle/10324/55918

    Título
    Correction of hyponatremia may be a treatment stratification biomarker: A two-stage systematic review and meta-analysis
    Autor
    Herrera Gómez, Francisco MagnoAutoridad UVA Orcid
    Monge Donaire, Diana
    Ochoa Sangrador, Carlos
    Bustamante Munguira, JuanAutoridad UVA Orcid
    Alamartine, Eric
    Álvarez González, Francisco JavierAutoridad UVA Orcid
    Año del Documento
    2018
    Editorial
    MDPI
    Descripción
    Producción Científica
    Documento Fuente
    Journal of Clinical Medicine, 2018, vol. 7, n. 9, p. 262
    Resumo
    Changes in serum sodium concentration ([Na+]serum) can permit evaluation of the treatment effect of vasopressin antagonists (vaptans) in patients with worsening heart failure (HF) or cirrhotic ascites; that is, they may act as a treatment stratification biomarker. A two-stage systematic review and meta-analysis were carried out and contextualized by experts in fluid resuscitation and translational pharmacology (registration ID in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42017051440). Meta-analysis of aggregated dichotomous outcomes was performed. Pooled estimates for correction of hyponatremia (normalization or an increase in [Na+]serum of at least 3–5 mEq/L) under treatment with vaptans (Stage 1) and for clinical outcomes in both worsening HF (rehospitalization and/or death) and cirrhotic ascites (ascites worsening) when correction of hyponatremia is achieved (Stage 2) were calculated. The body of evidence was assessed. Correction of hyponatremia was achieved under vaptans (odds ratio (OR)/95% confidence interval (95% CI)/I2/number of studies (n): 7.48/4.95–11.30/58%/15). Clinical outcomes in both worsening HF and cirrhotic ascites improved when correction of hyponatremia was achieved (OR/95% CI/I2/n: 0.51/0.26–0.99/52%/3). Despite the appropriateness of the study design, however, there are too few trials to consider that correction of hyponatremia is a treatment stratification biomarker. Patients with worsening HF or with cirrhotic ascites needing treatment with vaptans, have better clinical outcomes when correction of hyponatremia is achieved. However, the evidence base needs to be enlarged to propose formally correction of hyponatremia as a new treatment stratification biomarker. Markers for use with drugs are needed to improve outcomes related to the use of medicines.
    Materias Unesco
    32 Ciencias Médicas
    Palabras Clave
    Hyponatremia
    Biomarkers
    Drug evaluation
    Heart failure
    Ascites
    ISSN
    2077-0383
    Revisión por pares
    SI
    DOI
    10.3390/jcm7090262
    Patrocinador
    Junta de Castilla y León (VA161G18)
    Version del Editor
    https://www.mdpi.com/2077-0383/7/9/262
    Propietario de los Derechos
    © 2018 The Authors
    Idioma
    eng
    URI
    https://uvadoc.uva.es/handle/10324/55918
    Tipo de versión
    info:eu-repo/semantics/publishedVersion
    Derechos
    openAccess
    Aparece en las colecciones
    • DEP05 - Artículos de revista [198]
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    Correction-of-hyponatremia.pdf
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    Universidad de Valladolid

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