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Rarely prescribed torsemide may be optimal diuretic
Tosemide is effective for the treatment of HF, yet is rarely prescribed, according to a comparison study of three approved loop diuretics.
Researchers at Yale School of Medicine studied the proportion of adult patients with HF treated with torsemide, furosemide and bumetanide using the Perspective database of more than 500 US hospitals. From 2009 to 2010, among 274,515 discharged HF patients, 92% received a loop diuretic during their stay. Of those, 87% received furosemide, 3% received bumetanide, 0.4% received torsemide and 10% received a combination of the drugs.
“The available evidence suggests that newer loop diuretics and furosemide may not be identical. Although markedly limited by methodological problems and inadequate power, the few existing pharmacological and clinical studies propose that there might be superior and more consistent oral bioavailability, longer duration of action, improved tolerability and better outcomes with newer loop diuretics, particularly torsemide, as compared with furosemide,” researchers wrote in the research correspondence.
Based on the patterns of use in the current study, “There appears to be potential benefits from using torsemide compared with furosemide, but it is rarely used in practice. … [I]f the potential advantages of torsemide over furosemide are proven in subsequent comparative effectiveness studies, this drug might become the preferred treatment of chronic HF,”Behnood Bikdeli, MD, postdoctoral associate in cardiovascular medicine at the Yale Center for Outcomes Research and Evaluation, said in a press release.
Disclosure: Bikdeli is partially supported by a grant from the National Heart, Lung and Blood Institute. See the full study for a list of the researchers’ relevant financial disclosures.