No benefit with torsemide over furosemide for posthospitalization treatment of heart failure (TRANSFORM-HF)

Clinical Question

For patients discharged after hospitalization for acute heart failure, does long-term torsemide decrease all-cause mortality more than furosemide?

Bottom line

In this pragmatic trial, there was no difference in all-cause mortality when comparing torsemide with furosemide in patients following hospitalization for acute heart failure. However, interpretation of the study results is limited because of loss to follow-up, crossover of trial participants, and nonadherence to study drugs. Furthermore, new changes in guideline-directed medical therapy for heart failure — specifically, the addition of angiotensin receptor–neprilysin inhibitors and sodium-glucose cotransporter-2 inhibitors — may have affected outcomes as well as diuretic requirements over the course of the trial. 1b-

Study design: Randomized controlled trial (nonblinded)

Funding: Government

Setting: Inpatient (any location) with outpatient follow-up

Reviewer

Nita Shrikant Kulkarni, MD
Assistant Professor in Hospital Medicine
Northwestern University
Chicago, IL


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Comments

Anonymous

No advantage of newer more expensive options to Lassie

Good to know

Arup Kumar Dhara

Impact assessment

Very good