PMID- 30846351
OWN - NLM
STAT- MEDLINE
DCOM- 20200721
LR  - 20200721
IS  - 1544-3450 (Electronic)
IS  - 1086-5802 (Linking)
VI  - 59
IP  - 3
DP  - 2019 May-Jun
TI  - Comparing torsemide versus furosemide in patients with heart failure: A 
      meta-analysis.
PG  - 432-438
LID - S1544-3191(19)30024-X [pii]
LID - 10.1016/j.japh.2019.01.014 [doi]
AB  - OBJECTIVES: To compare the efficacy and safety of torsemide versus furosemide in 
      patients with heart failure (HF). DATA SOURCES: Medline, Cochrane Library, Web of 
      Science, and Google Scholar database searches for relevant articles from 1946 to 
      May 2018 were performed with the use of the key words torsemide and furosemide. 
      STUDY SELECTION: Studies were included if they met the following criteria: (1) 
      cohort studies or randomized controlled trials of adult patients 18 years of age 
      or older who received oral torsemide or furosemide for HF with reduced or 
      preserved ejection fraction; and (2) studies that reported mortality rate, 
      rehospitalization rate for HF or cardiovascular disease (CVD), or New York Heart 
      Association (NYHA) functional class changes. DATA EXTRACTION: Efficacy outcomes 
      were mortality from any cause, rehospitalization for HF, rehospitalization for 
      CVD, and NYHA functional class improvement. Safety outcome included hypokalemia. 
      RESULTS: In the 5 included studies, there was no significant difference in 
      mortality between torsemide and furosemide (odds ratio [OR] 1.00, 95% CI 
      0.58-1.72; P = 0.99; I(2) = 79%). There was no significant difference in 
      rehospitalization rates for HF (OR 0.79, 95% CI 0.57-1.09; P = 0.15; I(2) = 64%) 
      or CVD (OR 0.83, 95% CI 0.62-1.12; P = 0.22; I(2) = 40%) between torsemide- and 
      furosemide-treated patients. The use of torsemide was associated with significant 
      improvement in NYHA functional class compared with furosemide (OR 1.44, 95% CI 
      1.18-1.76; P = 0.0004; I(2) = 0%). CONCLUSION: Our meta-analysis showed that 
      torsemide is associated with statistically significant improvement in NYHA 
      functional class for patients with HF compared with furosemide. However, 
      torsemide did not provide significant benefits in reducing mortality or 
      rehospitalization rates for HF or CVD compared with furosemide. The authors 
      suggest switching from furosemide to torsemide in patients with HF not achieving 
      symptomatic control with the use of furosemide despite maximizing 
      guideline-directed medical therapy and furosemide dosing.
CI  - Copyright (c) 2019 American Pharmacists Association(R). Published by Elsevier Inc. 
      All rights reserved.
FAU - Kido, Kazuhiko
AU  - Kido K
FAU - Shimizu, Mikiko
AU  - Shimizu M
FAU - Hashiguchi, Masayuki
AU  - Hashiguchi M
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20190304
PL  - United States
TA  - J Am Pharm Assoc (2003)
JT  - Journal of the American Pharmacists Association : JAPhA
JID - 101176252
RN  - 7LXU5N7ZO5 (Furosemide)
RN  - W31X2H97FB (Torsemide)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiovascular Diseases/*drug therapy
MH  - Cohort Studies
MH  - Databases, Factual
MH  - Furosemide/adverse effects/*therapeutic use
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Hospitalization
MH  - Humans
MH  - Middle Aged
MH  - Mortality
MH  - New York
MH  - Patients
MH  - Randomized Controlled Trials as Topic
MH  - Torsemide/adverse effects/*therapeutic use
MH  - Treatment Outcome
EDAT- 2019/03/09 06:00
MHDA- 2020/07/22 06:00
CRDT- 2019/03/09 06:00
PHST- 2018/06/14 00:00 [received]
PHST- 2019/01/14 00:00 [revised]
PHST- 2019/01/24 00:00 [accepted]
PHST- 2019/03/09 06:00 [pubmed]
PHST- 2020/07/22 06:00 [medline]
PHST- 2019/03/09 06:00 [entrez]
AID - S1544-3191(19)30024-X [pii]
AID - 10.1016/j.japh.2019.01.014 [doi]
PST - ppublish
SO  - J Am Pharm Assoc (2003). 2019 May-Jun;59(3):432-438. doi: 
      10.1016/j.japh.2019.01.014. Epub 2019 Mar 4.