[Long-term diuretic treatment in heart failure: are there differences between furosemide and torasemide?].
BACKGROUND
Treatment for congestive heart failure (CHF) is an important factor in rising health care costs especially in patients requiring repeated hospitalisations. Diuretics remain the most frequently utilized drugs in symptomatic patients. In this study the long-term outcome under furosemide and torasemide, two loop diuretics with different pharmacokinetic properties, were evaluated during one year in an ambulatory care setting.


OBJECTIVE
Comparison of hospitalization rates and estimated costs under long-term treatment with furosemide and torasemide in patients with CHF.


METHODS
Retrospective analysis of disease course and resource utilization in 222 ambulatory patients receiving long-term treatment with furosemide (n = 111) or torasemide (n = 111). Data were also compared to those of a similar study including 1000 patients in Germany.


RESULTS
Patients receiving long-term treatment with torasemide had a lower hospitalisation rate (3.6%) compared to patients on furosemide (5.4%). Corresponding hospitalization rates in the German study were 1.4% under torasemide and 2% under furosemide. The higher hospitalisation rates in Swiss patients could be explained by a higher average age (75 years vs. 69 years) and a longer duration of symptomatic heart failure (4.1 yrs vs. 0.7 yrs). Cost estimates based on the average number of hospital days (0.54 under torasemide compared to 1.05 under furosemide) indicated that the financial burden could be halved by a long-term torasemide treatment.


CONCLUSIONS
Torasemide with its more complete and less variable bioavailability offers potential clinical and economic advantages over furosemide in the long-term treatment in patients with CHF.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D004232:Diuretics / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D005665:Furosemide / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D005858:Germany; D006333:Heart Failure / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D008134:Long-Term Care / Q000191:economics; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000191:economics; D012189:Retrospective Studies; D013449:Sulfonamides / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D013557:Switzerland; D000077786:Torsemide
D004232:Diuretics; D013449:Sulfonamides; D005665:Furosemide; D000077786:Torsemide
Diuretika-Langzeitbehandlung bei Herzinsuffizienz: Gibt es Unterschiede zwischen Furosemid und Torasemid?