Two drugs commonly used to treat patients with heart failure are no different from each other in their ability to improve patient survival, according to a new study.
Investigators compared outcomes in patients who were either treated with furosemide, an older, established drug, or the newer medication torsemide. Torsemide did not improve survival compared to furosemide, and there were similar rates of hospitalization with the two medications, the researchers reported.
The trial results have “immediate clinical applications,” and resolve a long-standing question of which drug may be more effective in protecting patients who are at a high risk of death, according to the National Institutes of Health, which supported the study.
“We’re not saying that patients don’t need diuretics. We’re saying that there’s no difference in the survival benefit of these two therapies,” added study co-author Robert J. Mentz, MD, of Duke University Medical Center in North Carolina, and colleagues. “This suggests we should be spending more time focusing on the right diuretic dose for our patients and working to treat patients with therapies that improve clinical outcomes in heart failure.”
Furosemide and torsemide are diuretics (water pills), which help to lessen fluid buildup in patients with heart failure, providing relief from congestion and breathing difficulties. Some studies have suggested that torsemide is more effective than furosemide in preventing deaths. The new study is one of the largest to examine outcomes associated with routine heart failure drugs, investigators said.
The trial participants included a high proportion of women (37%) and Black Americans (34%), who are often underrepresented in clinical studies of heart failure, the researchers noted.
“This study represents an important step in understanding how heart failure treatments affect all groups and may help reduce health disparities associated with this condition,” said study co-author Patrice Desvigne-Nickens, MD, of the National Heart, Lung, and Blood Institute.
The study was published in JAMA.