Rationale and design of a randomized trial to assess the effects of diuretics in heart failure: Japanese Multicenter Evaluation of Long- vs Short-Acting Diuretics in Congestive Heart Failure (J-MELODIC).
BACKGROUND
Diuretics are the most prescribed medication for heart failure (HF) patients, but clinical evidence of the long-term effects of diuretics are lacking. The present study was designed to compare the therapeutic effects of furosemide, a short-acting loop diuretic, and azosemide, a long-acting one, in patients with HF to test the hypothesis that long-acting diuretics are superior therapy.


RESULTS
The Japanese Multicenter Evaluation of LOng- vs short-acting Diuretics In Congestive heart failure (J-MELODIC) is a multicenter, prospective, randomized trial enrolling a total of 300 patients (150 patients in each group). The primary outcome is a composite of cardiovascular death and unplanned admission to hospital for congestive HF. Other outcomes include all-cause mortality, worsening of the symptoms of HF, or a need for modification of therapy. Serial assessment of echocardiographic and neurohumoral parameters will be conducted over a minimum follow-up period of 2 years.


CONCLUSIONS
The study results will provide important evidence for the treatment of chronic HF.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003692:Delayed-Action Preparations; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use*; D005665:Furosemide / Q000494:pharmacology / Q000627:therapeutic use*; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016037:Single-Blind Method; D013424:Sulfanilamides / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D013777:Tetrazoles; D013876:Thiophenes; D000096926:Benzenesulfonamides
D003692:Delayed-Action Preparations; D004232:Diuretics; D005665:Furosemide; D013424:Sulfanilamides; C018222:azosemide; D013777:Tetrazoles; D013876:Thiophenes; D000096926:Benzenesulfonamides