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Rigshospitalet - a part of Copenhagen University Hospital
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Dual Vasopressin Receptor Antagonism to Improve Congestion in Patients With Acute Heart Failure: Design of the AVANTI Trial

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Biomarkers and Their Relation to Cardiac Function Late After Peripartum Cardiomyopathy

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Biomarkers and Their Relation to Cardiac Function Late After Peripartum Cardiomyopathy

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Steven R Goldsmith
  • Daniel Burkhoff
  • Finn Gustafsson
  • Adriaan Voors
  • Faiez Zannad
  • Peter Kolkhof
  • Gerald Staedtler
  • Pablo Colorado
  • Wilfried Dinh
  • James E Udelson
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BACKGROUND: Loop diuretics are the main treatment for patients with acute heart failure, but are associated with neurohormonal stimulation and worsening renal function and do not improve long-term outcomes. Antagonists to arginine vasopressin may provide an alternative strategy to avoid these effects. The AVANTI study will investigate the efficacy and safety of pecavaptan, a novel, balanced dual-acting V1a/V2 vasopressin antagonist, both as adjunctive therapy to loop diuretics after admission for acute heart failure, and later as monotherapy.

METHODS AND RESULTS: AVANTI is a double-blind, randomized phase II study in 571 patients hospitalized with acute heart failure and signs of persistent congestion before discharge. In part A, patients will receive either pecavaptan 30 mg/d or placebo with standard of care for 30 days. In part B, eligible patients will continue treatment or receive pecavaptan or diuretics as monotherapy for another 30 days. The primary end points for part A are changes in body weight and serum creatinine; for part B, changes in body weight and blood urea nitrogen/creatinine ratio.

CONCLUSIONS: This study will provide the first evidence that a balanced V1a/V2 antagonist may safely enhance decongestion, both as an adjunct to loop diuretics and as an alternative strategy.

TRIAL REGISTRATION NUMBER: NCT03901729.

Original languageEnglish
JournalJournal of Cardiac Failure
Volume27
Issue number2
Pages (from-to)233-241
Number of pages9
ISSN1071-9164
DOIs
Publication statusPublished - Feb 2021

    Research areas

  • Congestive heart failure, decongestion, diuretic, vasopressin

ID: 62106219