Preliminary findings: No survival difference in heart failure in comparison of two common diuretics

Computerized illustration shows the human heart inside the chest cavity.

Two drugs widely used to treat adults with heart failure – furosemide and torsemide – showed no difference in their ability to improve patient survival when compared head-to-head, according to preliminary findings from a clinical trial supported by the NHLBI. Researchers presented their findings at the American Heart Association’s Scientific Sessions 2022 meeting.   

The trial, called TRANSFORM-HF, is one of the largest to date studying routine medications in heart failure, helps resolve a long-standing question about whether one drug is better than the other for treating this group of patients, who carry a high risk of death.  

Both drugs are so-called loop diuretics, or water pills, which help relieve congestion and breathing difficulties caused by fluid buildup in patients with heart failure. One drug, furosemide, which has been around for decades, is the most used diuretic to treat heart failure, while the other drug, torsemide, is a comparatively newer medicine. Past studies have suggested torsemide might have an advantage over furosemide in reducing deaths in this population with heart failure. 

For the trial, researchers studied 2,859 patients who had been hospitalized with heart failure at 60 medical centers across the United States. They randomly assigned them to a strategy of either furosemide or torsemide and followed them for an average of 17 months to track survival outcomes. The median age of the patients was 65 years. During the follow-up period, death occurred in 26.1% of those on torsemide and 26.2% of the patients on furosemide.  
The preliminary findings suggest that switching diuretics might not make a difference in treating heart failure, the researchers said. The findings also highlight the critical need for more effective, life-saving therapies for heart failure patients, they added, noting that future publication of the results in a peer-reviewed scientific journal is anticipated.