Torasemide versus furosemide in treatment of heart failure: A systematic review and meta‐analysis of randomized controlled trials

Sherif, Nourin Ali; Morra, Mostafa Ebraheem; Le, Thanh Van; Elsayed, Ghadeer Gamal; Elkady, Aya Hesham; Elshafay, Abdelrahman; Kien, Nguyen Dang; Al-Habbaa, Ahmed; Minh, Le Huu Nhat; Y, Mai Nhu; Nghia, Thai Le Ba; Mohammed, Abdelrhman Tarek; Eid, Peter Samuel; Turk, Tarek; Hirayama, Kenji; Huy, Nguyen Tien

doi:10.1111/jep.13261

Cited by 13 publications

(9 citation statements)

References 45 publications

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“…In the context of WHF and the consequent reduced bioavailability of oral loop diuretics, guidelines recommend the use of IV loop diuretics 5 to rapidly and more efficiently achieve a natriuretic ceiling 20 . Different loop diuretics exist and they have different pharmacokinetics and bioavailability 17 ; a large (∼6000 participants to be enrolled) ongoing trial is comparing oral torasemide to furosemide as treatment for congestion at the time of discharge from an episode of HF (TRANSFORM‐HF, NCT03296813 21 ) following the favourable effect of torasemide on HF hospitalizations suggested in observational studies and the meta‐analysis of small trials 22 …”

Section: Part I: Pathophysiological Background Relevant To Diureticsmentioning

confidence: 99%

“…20 Different loop diuretics exist and they have different pharmacokinetics and bioavailability 17 ; a large (∼6000 participants to be enrolled) ongoing trial is comparing oral torasemide to furosemide as treatment for congestion at the time of discharge from an episode of HF (TRANSFORM-HF, NCT03296813 21 ) following the favourable effect of torasemide on HF hospitalizations suggested in observational studies and the meta-analysis of small trials. 22 Thiazide-like diuretics can be used in severe HF patients who responded poorly to loop diuretics in a sequential nephron blockade strategy. These diuretic agents potentialize the natriuretic effect of loop diuretics (Figure 1) and in the case of oral and IV metolazone remain effective with reduced filtration rate (<30 ml/min/1.73 m 2 ).…”

Section: Part I: Pathophysiological Background Relevant To Diureticsmentioning

confidence: 99%

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Practical outpatient management of worsening chronic heart failure

Girerd

Mewton

Tartière³

et al. 2022

European J of Heart Fail

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Management of worsening heart failure (WHF) has traditionally been hospital-based, but with the rising burden of heart failure (HF), the pressure on healthcare systems exerted by this disease necessitates a different strategy than long (and costly) hospital stays. A strategy for outpatient intravenous (IV) diuretic treatment of WHF has been developed in certain American centres in the past 10 years, whereas European centres have been mostly favouring 'classic' in-hospital management of WHF. Embracing novel, outpatient approaches for treating WHF could substantially reduce the burden on healthcare systems while improving patient's satisfaction and quality of life. The present article is intended to provide essential knowledge and practical guidelines aimed at helping clinicians implement these new ambulatory approaches using day hospital and/or at-home hospitalization. The topics addressed by our group of HF experts include the pathophysiological background of diuretic therapy, the most suitable profile of WHF that may be managed in an ambulatory setting, the pharmacological protocols that can be used, as well as a detailed description of healthcare structures that can be proposed to deliver these ambulatory care interventions. The practical aspects of day hospital and hospital-at-home IV diuretic administration are specifically emphasized. The algorithm provided along with the practical IV diuretic protocols should assist HF clinicians in implementing this new approach in their local clinical setting.

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Section: Part I: Pathophysiological Background Relevant To Diureticsmentioning

confidence: 99%

Section: Part I: Pathophysiological Background Relevant To Diureticsmentioning

confidence: 99%

Practical outpatient management of worsening chronic heart failure

Girerd

Mewton

Tartière³

et al. 2022

European J of Heart Fail

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“…A 2011 nonblinded RCT (n5289) evaluated the effect of counseling and education, provided by a lactation consultant and peer counselor, on rates of breastfeeding initiation and duration. 2 The patients were predominantly African American (61% of total) women ranging in age…”

Section: Do Peer Support Lactation Interventions Increase Initiation ...mentioning

confidence: 99%

“…A 2019 systematic review and meta-analysis of 18 RCTs (N=1,598) compared torsemide and furosemide in patients with heart failure for urine output and other clinical outcomes. 2 Eight of the RCTs were included in the systematic review above. Mean age in the 18 studies ranged from 55 to 82.3 years old, and most of the studies included more male patients (range 39%–92%).…”

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confidence: 99%

Does torsemide relieve dyspnea and increase diuresis more than furosemide in patients with acute heart failure with reduced ejection fraction?

Fashner¹,

Espinoza²,

Garcés³

2021

EBPR

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“…There are a few published reviews on torasemide, some of which have focused on the comparative effects of furosemide and other diuretics,. [13][14][15][16][17] In contrast, other studies have emphasized the effects of loop diuretics in patients with CHF. [18][19][20] Until now, no systematic review has been conducted to ascertain the PK parameters and drug-drug interactions of torasemide.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Critical Review of Clinical Pharmacokinetics of Torasemide

Sherazi,

Zamir,

Rehman

et al. 2024

Therapeutic Drug Monitoring

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Purpose: Torasemide is a potassium-sparing loop diuretic used to treat fluid retention associated with congestive heart failure and kidney and hepatic diseases. This systematic review was conducted to combine all accessible data on the pharmacokinetics (PK) of torasemide in healthy and diseased populations, which may help clinicians avert adverse drug reactions and determine the correct dosage regimen. Methods: Four databases were systematically searched to screen for studies associated with the PK of torasemide, and 21 studies met the eligibility criteria. The review protocol was registered in the PROSPERO database (CRD42023390178). Results: A decrease in maximum plasma concentration (Cmax) was observed for torasemide after administration of the prolonged-release formulation in comparison to that after administration of the immediate-release formulation, that is, 1.12 ± 0.17 versus 1.6 ± 0.2 mcg/mL. After administering an oral dose of torasemide, a 2-fold increase in the area under the concentration–time curve (AUC) was reported in patients with congestive heart failure compared with the healthy population. Moreover, the patients with renal failure (clearance < 30 mL/min) showed an increase in value of AUC0–∞ that is, 42.9 versus 8.091 mcg.h−1.mL−1 compared with healthy subjects. In addition, some studies have reported interactions with different drugs, in which irbesartan showed a slight increase in the AUC0–∞ of torasemide, whereas losartan and empagliflozin did not. Conclusions: The current review summarizes all available PK parameters of torasemide that may be beneficial for avoiding drug–drug interactions in subjects with renal and hepatic dysfunction and for predicting doses in patients with different diseases.

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Torasemide versus furosemide in treatment of heart failure: A systematic review and meta‐analysis of randomized controlled trials

Cited by 13 publications

References 45 publications

Practical outpatient management of worsening chronic heart failure

Practical outpatient management of worsening chronic heart failure

Does torsemide relieve dyspnea and increase diuresis more than furosemide in patients with acute heart failure with reduced ejection fraction?

A Systematic Critical Review of Clinical Pharmacokinetics of Torasemide

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