An on-treatment modified analysis of the TRANSFORM-HF trial presented at the 2024 American College of Cardiology (ACC.24) Annual Scientific Sessions found significant differences in study results between torsemide and furosemide treatment in post-discharge heart failure hospitalizations. No significant changes were observed.

“Yet, we got the same results; there was no difference between these two drugs,” Velaprapas Kittipibul, M.D., a cardiologist and researcher at Duke University Medical Center, explained in an interview with HCPLive. Did. “Going back to your point, we shouldn’t be debating which one is better. How do we find the right dose for the right patient?”

TRANFORM-HF is an open-label, pragmatic study that randomly assigned older adults hospitalized with heart failure, regardless of ejection fraction, to either torsemide or furosemide in a 1:1 ratio from 60 centers in the United States. It was a test. Similar to the main finding, prespecified on-treatment analysis showed no difference, but the unknown diuretic status of many patients may have limited statistical power. there is.

This modified on-treatment analysis of TRANSFORM-HF included surviving patients with known or unknown diuretic status and assumed that patients would continue on their assigned diuretic unless confirmed otherwise. The on-treatment definition was applied both at discharge and at her 1-month follow-up. Outcomes of the analysis consisted of 12-month all-cause mortality and hospitalizations.

A total of 2570 and 2374 patients were included in the on-treatment analysis at discharge and 1-month follow-up, respectively. Of this population, 97 (4%) and 675 (28%) had unknown diuretic status at discharge and at his 1-month follow-up.

Analysis showed no significant difference in mortality between the torsemide and furosemide treatment groups at discharge (hazard ratio) [HR]1.01; P = .96) or 1 month (HR, 1.02; P = .90). Analyzes also revealed no significant difference in all-cause hospitalization between treatment groups at discharge (HR, 0.90; P = .12) and 1 month (HR, 0.91; P = .17).

To learn more about this research, read the full interview with Kittipibul on ACC.24.

References:

1. Kitty Pibble V, Mentz RJ, Claire RM, Modified on-treatment analysis of the effects of torsemide and furosemide after discharge in patients admitted with other heart failure: Results from Transform-HF. Presentation location: American College of Cardiology (ACC.24) Annual Scientific Sessions. April 6-8, 2024. Atlanta, Georgia.
2. Campbell P. Torsemide has no advantage over furosemide in terms of mortality or hospitalization for heart failure. HCP live. November 5, 2022. Accessed April 8, 2024. https://www.hcplive.com/view/torsemide-provides-no-benefit-over-furosemide-for-mortality-hospitalization-in-heart-failure.