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Letter to the Editor| Volume 57, e38-e40, November 2018

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Torsemide versus furosemide in heart failure patients: A meta-analysis of randomized controlled trials

Published:August 31, 2018DOI:https://doi.org/10.1016/j.ejim.2018.08.015
Torsemide versus furosemide in heart failure patients: A meta-analysis of randomized controlled trials
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      In 2012, total cost for heart failure (HF) was $30.7 billion and by 2030, it is projected to increase to $69.7 billion [
      • Mozaffarian D.
      • Benjamin E.L.
      • Go A.S.
      • Arnett D.K.
      • Blaha M.J.
      • Cushman M.
      • et al.
      Executive Summary: Heart Disease and Stroke Statistics-2016 Update.
      A Report From the American Heart Association Circulation. 2016; 133: e38-360
      ]. Hospitalizations for HF are a major reason for increased cost burden [
      • Buggey J.
      • Mentz R.J.
      • Pitt B.
      • Eisenstein E.L.
      • Anstrom K.J.
      • Velasquez E.
      • et al.
      A reappraisal of loop diuretic choice in heart failure patients.
      Am. Heart J. 2015; 169: 323-333
      ]. Loop diuretics are a part of standard therapy in symptomatic HF patients to decrease hospitalizations. Data from small randomized trials and observational studies have shown superiority of torsemide in reducing HF hospitalizations compared to furosemide [
      • Stroupe K.T.
      • Forthofer M.M.
      • Brater D.C.
      • Murray M.D.
      Healthcare costs of patients with Heart failure Treated with Torsemide or Furosemide.
      PharmocoEconomics. 2000; 17: 429-440
      ,
      • Murray M.D.
      • Deer M.M.
      • Ferguson J.A.
      • Dexter P.R.
      • Bennett S.J.
      • Perkins S.M.
      • et al.
      Open-label Randomized Trial of Torsemide compared with Furosemide for patients with Heart failure.
      Am. J. Med. 2001; 111: 513-520
      ,
      • Muller K.
      • Gamba G.
      • Jaquet F.
      • Hess B.
      Torsemide vs. furosemide in primary care patients with chronic heart failure NYHA II to IV-efficacy and quality of life.
      The European Journal of Heart Failure. 2003; 5: 793-801
      ,
      • Mentz R.J.
      • Hasselblad V.
      • Devore A.
      • Metra M.
      • Voors A.A.
      • Armstrong P.W.
      • et al.
      Torsemide versus Furosemide in patients with Acute Heart failure (from the ASCEND-HF Trial).
      Am. J. Cardiol. 2016; 117: 404-411
      ,
      • Mentz R.J.
      • Velasquez E.J.
      • Metra M.
      • McKendry C.
      • Chiswell K.
      • Fiuzat M.
      • et al.
      Comparative effectiveness of torsemide versus furosemide in heart failure patients: insights from the PROTECT trial.
      Futur. Cardiol. 2015; 11: 585-595
      ,
      • Mentz R.J.
      • Buggey J.
      • Fiuzat M.
      • Ersboll M.K.
      • Schulte P.J.
      • Devore A.D.
      • et al.
      Torsemide versus Furosemide in Heart failure patients: Insights from Duke University Hospital.
      J. Cardiovasc. Pharmacol. 2015; 65: 438-443
      ]. Despite that, >80% HF patients are on furosemide and < 10% are on torsemide [
      • Mentz R.J.
      • Hasselblad V.
      • Devore A.
      • Metra M.
      • Voors A.A.
      • Armstrong P.W.
      • et al.
      Torsemide versus Furosemide in patients with Acute Heart failure (from the ASCEND-HF Trial).
      Am. J. Cardiol. 2016; 117: 404-411
      ,
      • Mentz R.J.
      • Velasquez E.J.
      • Metra M.
      • McKendry C.
      • Chiswell K.
      • Fiuzat M.
      • et al.
      Comparative effectiveness of torsemide versus furosemide in heart failure patients: insights from the PROTECT trial.
      Futur. Cardiol. 2015; 11: 585-595
      ,
      • Mentz R.J.
      • Buggey J.
      • Fiuzat M.
      • Ersboll M.K.
      • Schulte P.J.
      • Devore A.D.
      • et al.
      Torsemide versus Furosemide in Heart failure patients: Insights from Duke University Hospital.
      J. Cardiovasc. Pharmacol. 2015; 65: 438-443
      ]. Hence, we performed a meta-analysis of randomized controlled trials (RCTs) comparing torsemide and furosemide in HF.

      Keywords

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      References

        • Mozaffarian D.
        • Benjamin E.L.
        • Go A.S.
        • Arnett D.K.
        • Blaha M.J.
        • Cushman M.
        • et al.
        Executive Summary: Heart Disease and Stroke Statistics-2016 Update.
        A Report From the American Heart Association Circulation. 2016; 133: e38-360
        View in Article
        • Buggey J.
        • Mentz R.J.
        • Pitt B.
        • Eisenstein E.L.
        • Anstrom K.J.
        • Velasquez E.
        • et al.
        A reappraisal of loop diuretic choice in heart failure patients.
        Am. Heart J. 2015; 169: 323-333
        View in Article
        • Stroupe K.T.
        • Forthofer M.M.
        • Brater D.C.
        • Murray M.D.
        Healthcare costs of patients with Heart failure Treated with Torsemide or Furosemide.
        PharmocoEconomics. 2000; 17: 429-440
        View in Article
        • Murray M.D.
        • Deer M.M.
        • Ferguson J.A.
        • Dexter P.R.
        • Bennett S.J.
        • Perkins S.M.
        • et al.
        Open-label Randomized Trial of Torsemide compared with Furosemide for patients with Heart failure.
        Am. J. Med. 2001; 111: 513-520
        View in Article
        • Muller K.
        • Gamba G.
        • Jaquet F.
        • Hess B.
        Torsemide vs. furosemide in primary care patients with chronic heart failure NYHA II to IV-efficacy and quality of life.
        The European Journal of Heart Failure. 2003; 5: 793-801
        View in Article
        • Mentz R.J.
        • Hasselblad V.
        • Devore A.
        • Metra M.
        • Voors A.A.
        • Armstrong P.W.
        • et al.
        Torsemide versus Furosemide in patients with Acute Heart failure (from the ASCEND-HF Trial).
        Am. J. Cardiol. 2016; 117: 404-411
        View in Article
        • Mentz R.J.
        • Velasquez E.J.
        • Metra M.
        • McKendry C.
        • Chiswell K.
        • Fiuzat M.
        • et al.
        Comparative effectiveness of torsemide versus furosemide in heart failure patients: insights from the PROTECT trial.
        Futur. Cardiol. 2015; 11: 585-595
        View in Article
        • Mentz R.J.
        • Buggey J.
        • Fiuzat M.
        • Ersboll M.K.
        • Schulte P.J.
        • Devore A.D.
        • et al.
        Torsemide versus Furosemide in Heart failure patients: Insights from Duke University Hospital.
        J. Cardiovasc. Pharmacol. 2015; 65: 438-443
        View in Article
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      Article info

      Publication history

      Published online: August 31, 2018
      Accepted: August 27, 2018
      Received: August 19, 2018

      Identification

      DOI: https://doi.org/10.1016/j.ejim.2018.08.015

      Copyright

      © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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