TORAFIC study protocol: torasemide prolonged release versus furosemide in patients with chronic heart failure

Dı́ez, Javier; Coca, António; E, de Teresa; Anguita, Manuel; Castro‐Beiras, Alfonso; Conthe, P.; Cobo, Erik; Fernández, E

doi:10.1586/erc.09.74

Cited by 17 publications

(15 citation statements)

References 38 publications

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“…Our partial findings about lower mortality compared furosemide was identical as in the Torasemide in Congestive Heart Failure Study (Diez et al, 2009). Torasemide differs from furosemide since it has a longer half-life and longer duration of action, and it may block the renin-angiotensin-aldosterone systems by inhibiting aldosterone binding to its receptor.…”

Section: Discussionsupporting

confidence: 71%

“…In other words, we can conclude that torasemide combined with ACEI has a superficial effect on LVEF compared with furosemide combined with ACEI, which provides reasons to widely use torasemide. Lower Ca 2+ sensitivity in force generation is reported to exist in patients with HF symptoms or occurrence of sudden death in these DCM patients (Diez et al, 2009). Thus, it inspires us to further investigate the molecular mechanism underlying the lower mortality of torasemide.…”

Section: Discussionmentioning

confidence: 98%

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Torasemide reduces dilated cardiomyopathy, complication of arrhythmia, and progression to heart failure

Han¹,

Guo²,

Lin³

et al. 2014

Genet. Mol. Res.

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ABSTRACT. The aim of this study was to analyze the incidence and types of arrhythmia and their relationship with the severity and prognosis of chronic heart failure (CHF) in patients with dilated cardiomyopathy (DCM), and to investigate the therapeutic effect of torasemide versus furosemide on CHF and incidence of arrhythmia. DCM patients with NYHA cardiac function II-IV were continuously monitored using a 24-h dynamic electrocardiogram (Holter), and arrhythmia incidence was analyzed by computer automatic analysis combined with manual assessment. In total, 125 participants were evenly divided into two groups: torasemide group which received 10 mg oral torasemide once daily) and regular anti-heart failure treatment (N = 65), and furosemide group which received torasemide (20 mg once daily orally) and regular antiheart failure treatment (N = 60). Another 60 normal healthy persons served as the normal control group. Incidence and severity of arrhythmia increased when degree of CHF was elevated. Size of left atrium was related to atrial fibrillation and size of left ventricle was related to malignant arrhythmia. At 3 months after treatment, cardiac function in both groups improved and incidence and severity of arrhythmia in both groups were reduced. However, left ventricular ejection fraction (LVEF) was higher in the torasemide group than in the furosemide group, while incidence of arrhythmia was lower in the torasemide group. Arrhythmias frequently occurred in patients with DCM and HF. Type of cardiac arrhythmia is closely related to ventricular enlargement and cardiac function grade. Torasemide is better for improving cardiac function to reduce arrhythmia and CHF compared to furosemide.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 98%

Torasemide reduces dilated cardiomyopathy, complication of arrhythmia, and progression to heart failure

Han¹,

Guo²,

Lin³

et al. 2014

Genet. Mol. Res.

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“…Furosemide and newer loop diuretics, such as bumetanide and torasemide, are widely known in human cardiology and commonly included in the therapeutic arsenal of CHF in conjunction with other therapeutic classes . In the ACVIM consensus guidelines for the diagnosis and treatment of canine DMVD, furosemide is the only recommended diuretic agent and consensus was reached to use it as the first‐line drug of both acute and chronic ACVIM stage C CHF for hospital‐based or home‐based therapy .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, resistance to furosemide might occur, requiring progressive increase in dose to maintain the same level of diuresis . Torasemide is a more recently developed loop diuretic with more potent and long‐lasting diuretic activity than furosemide . Torasemide is characterized by a longer half‐life (8 hours) and duration of action (12 hours), and a higher bioavailability (80–100%) than furosemide .…”

mentioning

confidence: 99%

Short‐Term Efficacy and Safety of Torasemide and Furosemide in 366 Dogs with Degenerative Mitral Valve Disease: The TEST Study

Chetboul

Pouchelon

Menard³

et al. 2017

Veterinary Internal Medicne

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BackgroundFurosemide is the only loop diuretic recommended by the ACVIM consensus guidelines for treatment of congestive heart failure (CHF) in dogs related to degenerative mitral valve disease (DMVD). Torasemide is another potent loop diuretic with a longer half‐life and a higher bioavailability.Objectives(1) To demonstrate that torasemide given once a day (q24h) is noninferior to furosemide given twice a day (q12h) for treating dogs with CHF; (2) and to compare the effect of the 2 drugs on the time to reach a composite cardiac endpoint “spontaneous cardiac death, euthanasia due to heart failure or CHF class worsening.”AnimalsA total of 366 dogs with CHF attributable to DMVD.MethodsAnalysis of 2 prospective randomized single‐blinded reference‐controlled trials was performed. Dogs orally received either torasemide q24h (n = 180) or furosemide q12h (n = 186) in addition to standard CHF therapy over 3 months. The primary efficacy criterion was the percentage of dogs with treatment success assessed in each study. The time to reach the composite cardiac endpoint was used as secondary criterion in the overall population.ResultsTorasemide was noninferior to furosemide (P torasemide − P furosemide = +7%; 95% CI [−8%; +22%] and P torasemide − P furosemide = +1%; 95% CI [−12%; +14%], respectively, in Study 1 and Study 2). Torasemide (median dose = 0.24 mg/kg/d q24h; range = 0.10–0.69 mg/kg/d) was associated with a 2‐fold reduction in the risk of reaching the composite cardiac endpoint (adjusted HR = 0.47; 95% CI = 0.27–0.82; P = 0.0077) as compared with furosemide (median dose = 1.39 mg/kg q12h; range = 0.70–6.30 mg/kg q12h).Conclusions and Clinical ImportanceTorasemide q24h is an effective oral diuretic in dogs with CHF.

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“…Allerdings sollte auch hierbei die Dosis stets individuell angepasst sein und die Patienten regelmäßig überwacht werden [4,20]. In unserer Analyse wurde das Schleifendiuretikum Furosemid häufiger als Torasemid verordnet, wobei letzteres, falls Schleifendiuretika eingesetzt werden müssen, aufgrund seiner etwas längeren Halbwertzeit bevorzugt werden könnte [5,20]. Zudem müssen wir davon ausgehen, dass ein nicht unerheblicher Teil der Pflegeheimbewohner harninkontinent und / oder mobilitätseinge-schränkt ist [22], was den Einsatz gerade stark wirksamer Diuretika zusätzlich problematisch macht.…”

Section: Verordnung Von Antihypertensiva Bei Geriatrischen Pflegeheimunclassified

Verordnung von Antihypertensiva bei geriatrischen Pflegeheimbewohnern in Deutschland

Kölzsch

Bolbrinker

Dräger

et al. 2010

Dtsch med Wochenschr

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Antihypertensive drugs account for a notable part (17 %) of all drug prescriptions in elderly residents of nursing homes throughout Germany. These results indicate that only a minority of all residents were treated with potentially inappropriate or potentially harmful drug combinations. However, the relatively high rate of prescriptions for loop diuretics is a matter of potential concern in this vulnerable group of patients.

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TORAFIC study protocol: torasemide prolonged release versus furosemide in patients with chronic heart failure

Abstract: This trial will test whether torasemide-PR possesses antifibrotic properties, which may provide an additional benefit beyond diuresis in patients with chronic heart failure.

Cited by 17 publications

References 38 publications

Torasemide reduces dilated cardiomyopathy, complication of arrhythmia, and progression to heart failure

Torasemide reduces dilated cardiomyopathy, complication of arrhythmia, and progression to heart failure

Short‐Term Efficacy and Safety of Torasemide and Furosemide in 366 Dogs with Degenerative Mitral Valve Disease: The TEST Study

Verordnung von Antihypertensiva bei geriatrischen Pflegeheimbewohnern in Deutschland

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