A novel opportunity to improve heart failure care: focusing on subcutaneous furosemide

Khan, Wahab J; Arriola-Montenegro, José; Mutschler, Melinda; Bensimhon, Daniel; Halmosi, Róbert; Tóth, Kálmán; Alexy, Tamás

doi:10.1007/s10741-023-10331-4

Cited by 3 publications

(2 citation statements)

References 56 publications

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“…Historically, most patients with HF have not had an option for IV diuretics outside of an emergency department or hospital admission ( 39 ). However, multiple recent studies have suggested that the use of outpatient IV diuretics is safe and effective in treatment of volume overload and reducing hospitalization ( 38 , 40 – 44 ).…”

Section: Introductionmentioning

confidence: 99%

“…The use of subcutaneous furosemide for ambulatory management of decompensated HF is a promising recent development, particularly given the challenge of access to outpatient IV diuretics and it overcomes the suboptimal efficacy of oral medications. It has a favorable safety and efficacy profile and represents another outpatient option for the treatment of volume overload ( 39 ).…”

Section: Introductionmentioning

confidence: 99%

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Systems of care for ambulatory management of decompensated heart failure

Badrish,

Sheifer,

Rosner

2024

Front. Cardiovasc. Med.

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Heart failure (HF) represents a worldwide health burden and the annual per patient cost to treat HF in the US is estimated at $24,383, with most of this expense driven by HF related hospitalizations. Decompensated HF is a leading cause for hospital admissions and is associated with an increased risk of subsequent morbidity and mortality. Many hospital admissions for decompensated HF are considered preventable with timely recognition and effective intervention.Systems of care that include interventions to facilitate early recognition, timely and appropriate intervention, intensification of care, and optimization to prevent recurrence can help successfully manage decompensated HF in the ambulatory setting and avoid hospitalization.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Systems of care for ambulatory management of decompensated heart failure

Badrish,

Sheifer,

Rosner

2024

Front. Cardiovasc. Med.

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The Role of Subcutaneous Furosemide in Heart Failure Management: A Systematic Review

Widiarti,

Saputra,

Ariyanto

et al. 2024

Curr Cardiol Rep

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Background Acute decompensated heart failure (ADHF) patients with symptomatic congestion often require in-hospital admission for intravenous (IV) diuretic, impacting both patient well-being and healthcare expenses. Subcutaneous (SC) furosemide has a potential to facilitate outpatient management of ADHF patients. Thus, this study aims to assess the efficacy and safety of SC furosemide utilization, offering a potential alternative to traditional IV administration. Methods A systematic search was conducted until April 14 2024 across scientific databases. This review included studies comparing SC furosemide with oral and IV formulations in adult HF patients. Results This study analyzed 687 patients from 20 studies. The results demonstrate that SC furosemide can effectively manage symptomatic congestion in HF patients and results in significant cost reductions, symptom relief, and improved quality of life. Although further investigation into mortality rates is needed, SC furosemide demonstrates efficacy comparable to IV furosemide in diuresis and weight loss, with similar bioavailability and natriuretic effects. Adverse events are generally minor, predominantly related to skin irritation. Innovative strategies, such as developing isotonic alkaline solutions and improved infusion devices, are being explored to address these challenges. Conclusion SC furosemide offers a promising alternative for managing ADHF, particularly in symptomatic HF patients with volume overload. The integration of SC furosemide into routine clinical practice and future guidelines, could optimize the management of HF, reducing hospital admission and improving patient outcomes.

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