In a study from Duke University, scientists found two drugs widely used to treat adults with heart failure—furosemide and torsemide—showed no difference in their ability to improve patient survival when compared.
The study is one of the largest to date studying routine medications in heart failure.
It helps resolve a long-standing question about whether one drug is better than the other for treating this group of patients, who carry a high risk of death.
Both drugs are diuretics, or water pills, which help relieve congestion and breathing difficulties caused by fluid buildup in patients with heart failure.
Furosemide, which was discovered decades ago, is the most-used diuretic to treat heart failure. The other drug, torsemide, is a comparatively newer medicine.
Previous studies have suggested torsemide might have an advantage over furosemide in reducing deaths due to heart failure, but this question remained unresolved.
In the current study, the team examined 2,859 older patients who had been hospitalized with heart failure at 60 medical centers across the United States.
These people were assigned to a strategy of either furosemide or torsemide and followed them for an average of 17 months to track survival outcomes.
During the follow-up period, death occurred in 26.1% of those on torsemide and 26.2% of the patients on furosemide.
Overall, the study showed that torsemide did not improve survival compared to furosemide in this high-risk population of patients with heart failure, and they also found similar rates of hospitalization with the two medications.
This suggests doctors should be spending more time focusing on the right diuretic dose for their patients and working to treat patients with therapies that improve clinical outcomes in heart failure.
The team agreed that the high death rate among those patients with heart failure during the trial is concerning, given the use of good guideline-based treatments during this study.
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The study was conducted by Robert J. Mentz et al and published in the Journal of the American Medical Association.
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