Comparison of the Efficacy and Saftey of 5 Mg/ 10 Mg Torasemide (To) in Patients with Chronic Heart Failure

Achhammer, I.; Häcker, W.; Glocke, M

doi:10.1007/978-1-4613-2067-8_84

Cited by 3 publications

(5 citation statements)

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“…The results of this open‐label, cohort study showed that torasemide is a safe, well tolerated and efficacious diuretic treatment in CHF patients, thus confirming the results of previous studies [24,25]. Although not designed as a mortality study, torasemide treatment was associated with a significantly lower total mortality and cardiac mortality.…”

Section: Discussionsupporting

confidence: 86%

Torasemide in chronic heart failure: results of the TORIC study

Cosı́n¹,

Dı́ez

2002

European J of Heart Fail

243

143

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Background: Diuretics such as torasemide are commonly used to treat chronic heart failure (CHF). Aims: The objective of the TOrasemide In Congestive Heart Failure (TORIC) Study was to investigate the safety, tolerability and efficacy of torasemide in CHF patients compared to furosemide or other diuretics in an open-label, non-randomised, post-marketing surveillance trial.Methods: The present analysis shows the findings of 1377 patients with New York Heart Association (NYHA) class II-III CHF who received diuretic therapy with torasemide 10 mgyday orally (ns778) vs. patients who received furosemide 40 mgyday orally (ns527) or other diuretics (ns72) on top of their existing standard CHF therapy for 12 months. Besides safety and tolerability, efficacy was assessed by documentation of mortality, morbidity, functional class and serum potassium levels every 3 months. Results: TORIC confirmed the safety and tolerability of torasemide in CHF patients. Mortality was significantly lower in the torasemide (ns17, 2.2%) than in the furosemideyother diuretics group (ns27, 4.5%) (P-0.05). Functional improvement as assessed by NYHA class was observed in more patients who received furosemide torasemide (ns356, 45.8%) than those who received furosemideyother diuretics (ns223, 37.2%) (Ps0.00017). At the end of the study abnormally low serum potassium levels were observed in fewer torasemide (ns95, 12.9%) than furosemideyother diuretics patients (ns102, 17.9%) (Ps0.013). Conclusion: Torasemide is safe and well tolerated in CHF patients. Although not designed as a mortality study, TORIC suggests a lower mortality amongst CHF patients treated with torasemide compared to furosemideyother diuretics. A functional improvement and a lower incidence of abnormal serum potassium levels were also observed in patients receiving torasemide as compared to those receiving furosemideyother diuretics.

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Section: Discussionsupporting

confidence: 86%

Torasemide in chronic heart failure: results of the TORIC study

Cosı́n¹,

Dı́ez

2002

European J of Heart Fail

243

143

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“…The 83 patients without edema before starting torsemide remained free of edema throughout the trial [41] Herchuelz et al (1988) 18…”

Section: Commentsmentioning

confidence: 95%

“…In summary, when compensated CHF patients are switched from 40 mg of furosemide to 5-10 mg of torsemide, there is a significant improvement in weight (most likely due to improved diuresis) and edema [41].…”

Section: Archhammer Et Al (1988)mentioning

confidence: 99%

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Should Torsemide Be the Loop Diuretic of Choice in Systolic Heart failure?

DiNicolantonio

2012

Future Cardiol.

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Furosemide is the most widely prescribed loop diuretic in the setting of systolic heart failure (HF), yet torsemide has been shown to have less inter- and intra-individual variation in bioavailability and a longer duration of action compared with furosemide. Thus, a systematic review and meta-analysis of randomized controlled trials comparing torsemide versus furosemide in patients with systolic HF using OVID MEDLINE, Excerpta Medica (Embase), Web of Science, PubMed and Google Scholar was performed. Extracted data included study design, sample characteristics, intervention, outcomes and control for potential confounding factors. A DerSimonian and Laird random-effects model was used to compute summary risk ratios for HF and cardiovascular (CV) readmission outcomes. Two randomized trials comparing furosemide with torsemide in 471 patients with systolic HF were identified. Compared to furosemide, torsemide significantly reduced total HF readmissions (relative risk [RR]: 0.41, 95% CI: 0.28-0.61, p < 0.0001) and HF readmissions (RR: 0.53, 95% CI: 0.33-0.84, p = 0.008) as well as CV readmissions (RR: 0.77, 95% CI: 0.60-0.98, p = 0.03) in patients with "at least 1 readmission." Moreover, compared with furosemide, torsemide caused a 14% reduction in all-cause mortality (RR: 0.86 [0.53-1.39], p = 0.54). Compared with furosemide, torsemide significantly reduces HF and CV-related hospital readmissions in systolic HF. Furthermore, torsemide is associated with a trend in reducing all-cause mortality.

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“…The higher bioavailability and less variability of bioavailability of torasemide compared to furosemide suggest that torasemide achieves more consistent concentrations of the drug in the body and therefore more efficient and steady diuresis than furosemide. This could be directly reflected as a difference in changes in body water and body weight between torasemide and furosemide treatment, as shown by the study of Achhammer et al [41]. In their report of multicenter trial in 246 CHF patients, 40 mg of furosemide was switched to 5-20 mg of torasemide in a randomized double-blind manner.…”

Section: Clinical Datamentioning

confidence: 91%

Torasemide for the Treatment of Heart Failure

Ishido¹,

Senzaki

2008

CHDDT

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Diuretics play an essential role in modern cardiovascular therapy, and are currently recommended for the treatment of congestive heart failure. Torasemide has been developed as a newer type of loop diuretic with a longer half-life, longer duration of action, and higher bioavailability compared to the most commonly used loop diuretic, furosemide. Torasemide also appears to have additional actions beyond the pure diuretic effect, such as anti-aldosterone effect and vasorelaxation effect. Studies have also investigated whether the superior pharmacokinetics and pharmacological activity of torasemide result in a favorable clinical outcome. Their results have indicated that, in comparison with furosemide, torasemide improves left ventricular function, reduces mortality as well as the frequency and duration of heart failure-related hospitalization, and improves quality of life, exercise tolerance and NYHA functional class in patients with congestive heart failure. Thus, torasemide appears to be a promising loop diuretic that contributes to a better management of patients with heart failure. Definitive clinical trials in a double-blind fashion are warranted.

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Comparison of the Efficacy and Saftey of 5 Mg/ 10 Mg Torasemide (To) in Patients with Chronic Heart Failure

Cited by 3 publications

References 0 publications

Torasemide in chronic heart failure: results of the TORIC study

Torasemide in chronic heart failure: results of the TORIC study

Should Torsemide Be the Loop Diuretic of Choice in Systolic Heart failure?

Torasemide for the Treatment of Heart Failure

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