In the article, Professor Guy Decaux, Erasmus University Hospital, Brussels, Belgium, and colleagues noted that vaptans can be taken orally or intravenously and work by competing with vasopressin hormone molecules for the same receptor "active sites" on cells, thus blocking the action of vasopressin.

Various subclasses of vaptan have been developed or are in development. Relcovaptan has shown initial positive results in the treatment of dysmenorrhoea, Raynaud's disease, and tocolysis.

A second subclass of vaptans, which target a different cell receptor site, include mozavaptan, lixivaptan, satavaptan, and tolvaptan. These drugs induce diuresis without the loss of mineral salts from the body that accompanies the use of other diuretics. This class of vaptans can be used to treat hyponatraemia. Conivaptan is the only vaptan currently approved by the US Food and Drug Administration for the treatment of hyponatraemia. Drugs in this class are in development to treat a number of conditions, including renal failure related to polycystic kidney disease, diabetic nephropathy, cirrhosis, and depression.

There also have been promising preliminary studies of vaptans for the treatment of glaucoma, Meniere's disease, brain haemorrhage, and small-cell cancer.

SOURCE: The Lancet

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