Thomas M, Gois PHF, Butcher BE, et al. - Analysis of the real-world IMADJIN dataset revealed a 76% persistence to tolvaptan. Discontinuation attributable to hepatic events was low.

• Before October 2020 access to tolvaptan in Australia was restricted by a controlled monitoring and distribution program called IMADJIN.

• In this retrospective, secondary data analysis of the IMADJIN dataset, experts focused on the time to all-cause discontinuation of tolvaptan in Australia.

• Of 479 autosomal dominant polycystic kidney disease patients included, the Kaplan-Meier estimation of 12-month persistence was 76.7%, and 23.8% discontinued treatment.

• Younger patients were more likely to discontinue tolvaptan than older ones therefore prescribers are advised to take extra care when initiating treatment in the former group.

• Aquaretic tolerability (4.2%), hepatic adverse events (abnormal liver function tests) (2.1%), disease progression (1.5%), and acute kidney injury (0.2%) were noted to be the reasons for discontinuation.

• A shorter time to discontinuation was observed in patients exhibiting a lack of aquaretic tolerance.