TRANSFORM-HF
Trial question
Is torsemide superior to furosemide in patients hospitalized with HF?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
37.0% female
63.0% male
N = 2859
2859 patients (1058 female, 1801 male).
Inclusion criteria: in-hospital patients with new or worsening HF.
Key exclusion criteria: RRT; heart transplant; implant anticipated in < 3 months; life expectancy < 12 months; known hypersensitivity to study drugs.
Interventions
N=1431 torsemide (oral dose left to the treating physician).
N=1428 furosemide (oral dose between 2:1 and 4:1 of torsemide's).
Primary outcome
All-cause mortality
26.1%
26.2%
26.2 %
19.6 %
13.1 %
6.5 %
0.0 %
Torsemide
Furosemide
No significant
difference ↔
No significant difference in all-cause mortality (26.1% vs. 26.2%; HR 1.02, 95% CI 0.89 to 1.18).
Secondary outcomes
No significant difference in all-cause mortality or hospitalization at 12 months (47.3% vs. 49.3%; HR 0.92, 95% CI 0.83 to 1.02).
No significant difference in total hospitalizations at 12 months (37.5% vs. 40.4%; RR 0.94, 95% CI 0.84 to 1.07).
Conclusion
In in-hospital patients with new or worsening HF, torsemide was not superior to furosemide with respect to all-cause mortality.
Reference
Frederik H Verbrugge, Venu Menon. Torsemide comparison with furosemide for management of heart failure (TRANSFORM-HF) trial. Eur Heart J Acute Cardiovasc Care. 2022 Dec 27;11(12):931-932.
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