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dc.contributor.authorHerrera Gómez, Francisco Magno 
dc.contributor.authorMonge Donaire, Diana
dc.contributor.authorOchoa Sangrador, Carlos
dc.contributor.authorBustamante Munguira, Juan 
dc.contributor.authorAlamartine, Eric
dc.contributor.authorÁlvarez González, Francisco Javier 
dc.date.accessioned2022-10-10T12:30:24Z
dc.date.available2022-10-10T12:30:24Z
dc.date.issued2018
dc.identifier.citationJournal of Clinical Medicine, 2018, vol. 7, n. 9, p. 262es
dc.identifier.issn2077-0383es
dc.identifier.urihttps://uvadoc.uva.es/handle/10324/55918
dc.descriptionProducción Científicaes
dc.description.abstractChanges 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.es
dc.format.mimetypeapplication/pdfes
dc.language.isoenges
dc.publisherMDPIes
dc.rights.accessRightsinfo:eu-repo/semantics/openAccesses
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subject.classificationHyponatremiaes
dc.subject.classificationBiomarkerses
dc.subject.classificationDrug evaluationes
dc.subject.classificationHeart failurees
dc.subject.classificationAsciteses
dc.titleCorrection of hyponatremia may be a treatment stratification biomarker: A two-stage systematic review and meta-analysises
dc.typeinfo:eu-repo/semantics/articlees
dc.rights.holder© 2018 The Authorses
dc.identifier.doi10.3390/jcm7090262es
dc.relation.publisherversionhttps://www.mdpi.com/2077-0383/7/9/262es
dc.identifier.publicationfirstpage262es
dc.identifier.publicationissue9es
dc.identifier.publicationtitleJournal of Clinical Medicinees
dc.identifier.publicationvolume7es
dc.peerreviewedSIes
dc.description.projectJunta de Castilla y León (VA161G18)es
dc.identifier.essn2077-0383es
dc.rightsAtribución 4.0 Internacional*
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersiones
dc.subject.unesco32 Ciencias Médicases


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