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Torasemide versus furosemide in treatment of heart failure: A systematic review and meta‐analysis of randomized controlled trials
Author(s) -
Sherif Nourin Ali,
Morra Mostafa Ebraheem,
Thanh Le Van,
Elsayed Ghadeer Gamal,
Elkady Aya Hesham,
Elshafay Abdelrahman,
Kien Nguyen Dang,
ALHABBAA Ahmed,
Minh Le Huu Nhat,
Y Mai Nhu,
Nghia Thai Le Ba,
Mohammed Abdelrhman Tarek,
Eid Peter Samuel,
Turk Tarek,
Hirayama Kenji,
Huy Nguyen Tien
Publication year - 2020
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.13261
Subject(s) - furosemide , medicine , loop diuretic , randomized controlled trial , heart failure , diuretic , confidence interval , ejection fraction , peripheral edema , meta analysis , strictly standardized mean difference , adverse effect
Aim Diuretics are a cornerstone in treatment of heart failure (HF). Torasemide is a loop diuretic with a potential advantage over other diuretics. We aim to meta‐analyse and compare the effect of torasemide with furosemide in HF patients. Methods A comprehensive literature search using 12 databases including PubMed, Scopus, and Web of Science was performed. All randomized controlled trials (RCTs) comparing furosemide and torasemide in HF patients were included and meta‐analysed. We assessed the risk of bias using Cochrane Collaboration's tool. The protocol was registered in PROSPERO (CRD42016046112). Results Eighteen RCTs with 1598 patients were included. There was a significant difference between torasemide 20 mg and furosemide 40 mg in increasing the urine volume (standard difference of the mean (SDM) [95% confidence interval] = −0.78 [−1.52 to −0.053], P = .036). Torasemide 10 mg and 10 to 20 mg have a significant effect on potassium excretion in comparison with furosemide 25 to 40 mg ( P = .018 and .023, respectively). In general, torasemide and furosemide have no significant difference in mortality, edema improvement, weight loss, heart rate, and reducing systolic/diastolic blood pressure. However, oral torasemide has a significant lower hospital stay P < .001 and superior effect in improving ejection fraction P = .029. Conclusion Although not all results are statistically significant, torasemide has potential advantages on multiple aspects of HF management when compared with furosemide. More studies are needed to clarify these effects.