Comparative effectiveness of torasemide versus furosemide in symptomatic therapy in heart failure patients: Preliminary results from the randomized TORNADO trial.
Aged
Comparative Effectiveness Research
Exercise Tolerance
/ drug effects
Female
Furosemide
/ adverse effects
Heart Failure
/ diagnosis
Humans
Male
Pilot Projects
Poland
Preliminary Data
Recovery of Function
Sodium Potassium Chloride Symporter Inhibitors
/ adverse effects
Time Factors
Torsemide
/ adverse effects
Treatment Outcome
heart failure
hospitalization
loop diuretics
prognosis
symptoms
Journal
Cardiology journal
ISSN: 1898-018X
Titre abrégé: Cardiol J
Pays: Poland
ID NLM: 101392712
Informations de publication
Date de publication:
2019
2019
Historique:
received:
09
07
2019
accepted:
23
11
2019
revised:
17
11
2019
pubmed:
8
1
2020
medline:
4
8
2020
entrez:
8
1
2020
Statut:
ppublish
Résumé
Recent reports suggest that torasemide might be more beneficial than furosemide in patients with symptomatic heart failure (HF). The aim was to compare the effects of torasemide and furosemide on clinical outcomes in HF patients. This study pilot consisted of data from the ongoing multicenter, randomized, unblinded endpoint phase IV TORNADO (NCT01942109) study. HF patients in New York Heart Association (NYHA) II-IV class with a stable dose of furosemide were randomized to treatment with equipotential dose of torasemide (4:1) or continuation of unchanged dose of furosemide. On enrollment and control visit (3 months after enrollment) clinical examination, 6-minute walk test (6MWT) and assessment of fluid retention by ZOE Fluid Status Monitor were performed. The primary endpoint was a composite of improvement of NYHA class, improvement of at least 50 m during 6MWT and decrease in fluid retention of at least 0.5 W after 3-months follow-up. The study group included 40 patients (median age 66 years; 77.5% male). During follow-up 7 patients were hospitalized for HF worsening (3 in torasemide and 4 in furosemide-treated patients). The primary endpoint reached 15 (94%) and 14 (58%) patients on torasemide and furosemide, respectively (p = 0.03). In HF patients treated with torasemide fluid overload and symptoms improved more than in the furosemide group. This positive effect occurred already within 3-month observation.
Sections du résumé
BACKGROUND
Recent reports suggest that torasemide might be more beneficial than furosemide in patients with symptomatic heart failure (HF). The aim was to compare the effects of torasemide and furosemide on clinical outcomes in HF patients.
METHODS
This study pilot consisted of data from the ongoing multicenter, randomized, unblinded endpoint phase IV TORNADO (NCT01942109) study. HF patients in New York Heart Association (NYHA) II-IV class with a stable dose of furosemide were randomized to treatment with equipotential dose of torasemide (4:1) or continuation of unchanged dose of furosemide. On enrollment and control visit (3 months after enrollment) clinical examination, 6-minute walk test (6MWT) and assessment of fluid retention by ZOE Fluid Status Monitor were performed. The primary endpoint was a composite of improvement of NYHA class, improvement of at least 50 m during 6MWT and decrease in fluid retention of at least 0.5 W after 3-months follow-up.
RESULTS
The study group included 40 patients (median age 66 years; 77.5% male). During follow-up 7 patients were hospitalized for HF worsening (3 in torasemide and 4 in furosemide-treated patients). The primary endpoint reached 15 (94%) and 14 (58%) patients on torasemide and furosemide, respectively (p = 0.03).
CONCLUSIONS
In HF patients treated with torasemide fluid overload and symptoms improved more than in the furosemide group. This positive effect occurred already within 3-month observation.
Identifiants
pubmed: 31909470
pii: VM/OJS/J/65083
doi: 10.5603/CJ.a2019.0114
pmc: PMC8083045
doi:
Substances chimiques
Sodium Potassium Chloride Symporter Inhibitors
0
Furosemide
7LXU5N7ZO5
Torsemide
W31X2H97FB
Types de publication
Clinical Trial, Phase IV
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
661-668Références
J Am Pharm Assoc (2003). 2019 May - Jun;59(3):432-438
pubmed: 30846351
J Cardiovasc Pharmacol. 2009 Jun;53(6):468-73
pubmed: 19430310
Clin Pharmacol Ther. 1995 Jun;57(6):601-9
pubmed: 7781259
Cardiovasc Drugs Ther. 2019 Feb;33(1):77-86
pubmed: 30649675
Pharmacoeconomics. 2001;19(6):679-703
pubmed: 11456215
Heart. 2006 Oct;92(10):1434-40
pubmed: 16621879
J Cardiovasc Pharmacol. 2015 May;65(5):438-43
pubmed: 25945862
Future Cardiol. 2012 Sep;8(5):707-28
pubmed: 23013124
Circ J. 2003 May;67(5):384-90
pubmed: 12736474
J Am Coll Cardiol. 2004 Jun 2;43(11):2028-35
pubmed: 15172408
Eur J Clin Pharmacol. 1986;31 Suppl:29-34
pubmed: 3536530
Am Heart J. 2015 Mar;169(3):323-33
pubmed: 25728721
Life Sci. 1998;63(3):PL45-50
pubmed: 9698054
Pharmacoeconomics. 2000 May;17(5):429-40
pubmed: 10977385
Eur J Pharmacol. 1991 Nov 26;205(2):145-50
pubmed: 1812004
Crit Care. 2015 Sep 03;19:296
pubmed: 26335137
Int J Clin Pract. 1998 Oct;52(7):467-71
pubmed: 10622087
Drug Des Devel Ther. 2015 Aug 05;9:4291-302
pubmed: 26273191
Eur Heart J. 2016 Jul 14;37(27):2129-2200
pubmed: 27206819
Am J Cardiol. 2016 Feb 1;117(3):404-11
pubmed: 26704029
Kardiol Pol. 2015;73(3):225-32
pubmed: 25791979
Pol Arch Intern Med. 2017 Oct 31;127(10):657-665
pubmed: 28786405
Eur J Heart Fail. 2002 Aug;4(4):507-13
pubmed: 12167392
Trials. 2017 Jan 23;18(1):36
pubmed: 28114980