Serum Copeptin Rises After Tolvaptan for Hyponatraemia, but Does Not Predict Risk of Rapid Sodium Rise: Pre‐Specified Secondary Analysis of the TVFR Trial
Primary result · Serum copeptinResult — go to the resultMean adjusted difference 8.4 pmol/L 95% CI 2.1–14.6Authors' conclusion
Tolvaptan increased serum copeptin compared to fluid restriction.
Study context
- Population
- Hospitalised patients with plasma sodium 115–130 mmol/L, single-centre tertiary hospital, Melbourne, Australia45 with copeptin results
- Participants
- 54 patients
- Comparison
- Tolvaptan vs fluid restriction for 3 days
- Tolvaptann = 25
- FRn = 20reference
- Primary endpoint
- Change in serum copeptin
- Follow-up
- Baseline to completion (Day 4, or discharge if sooner)
Methodological detailspre-specified, open-label, single-centre
- Pre-specified
- Open-label
- Single-centre
Primary result
Serum copeptin · over 3 days
Mean adjusted difference
8.4 pmol/L
95% CI 2.1–14.6
P = 0.01
Tolvaptanvs FR
mean adjusted difference 8.4 pmol/L (95% CI 2.1–14.6); P = 0.01
As reported in the abstract
Further findings
Baseline copeptin · mean baseline
- Mean baseline copeptin
- 10.4 pmol/L
Plasma sodium
- pNa increased in both groups, significantly more with tolvaptan
Prediction of rapid sodium rise
- Baseline copeptin did not predict rapid sodium rise
Original publication
Serum Copeptin Rises After Tolvaptan for Hyponatraemia, but Does Not Predict Risk of Rapid Sodium Rise: Pre‐Specified Secondary Analysis of the TVFR Trial. Clin Endocrinol (Oxf). Published 3 August 2026. doi:10.
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