Efficacy of oral torasemide in dogs with degenerative mitral valve disease and new onset congestive heart failure: The CARPODIEM study
Background Torasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs. Objective Evaluate the efficacy and safety of torasemide compared to furosemide in dogs with first occurrence of CHF caused by degenerative mitral valve disease (DMVD). Animals Three hundr...
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Published in | Journal of veterinary internal medicine Vol. 34; no. 5; pp. 1746 - 1758 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Hoboken, USA
John Wiley & Sons, Inc
01.09.2020
Wiley |
Subjects | |
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Abstract | Background
Torasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs.
Objective
Evaluate the efficacy and safety of torasemide compared to furosemide in dogs with first occurrence of CHF caused by degenerative mitral valve disease (DMVD).
Animals
Three hundred and nineteen dogs with new onset CHF attributable to DMVD.
Methods
Double‐blinded randomized noninferiority study of PO torasemide vs furosemide in addition to standard CHF treatment. The primary efficacy criterion was decreased pulmonary edema and cough and no worsening of dyspnea or exercise tolerance at day 14. Secondary endpoints included clinical response at day 84 and time to death, euthanasia, or premature study withdrawal for cardiac reasons.
Results
Torasemide q24h (n = 161) was noninferior to furosemide q12h (n = 158); percentage of dogs meeting primary efficacy criterion at day 14 was similar between groups (torasemide, 74.4% [95% confidence interval (CI), 66.8%‐81.0%] vs. furosemide, 73.5% [95% CI, 65.7%‐80.4%]; risk ratio [RR], 1.01; 95% CI, 0.89‐1.15; P = .87). Efficacy at day 84 showed similar results (RR, 1.05; 95% CI, 0.88‐1.25; P = .6). Dogs receiving torasemide had a longer time to endpoint and were less than half as likely to experience death, euthanasia, or premature study withdrawal (hazard ratio, 0.36; 95% CI, 0.19‐0.65; P = .001) than dogs receiving furosemide at any time during the study.
Conclusion and Clinical importance
Torasemide was noninferior to furosemide as first line PO treatment for new onset CHF caused by DMVD. Torasemide significantly decreased risk of cardiac‐related death or premature study withdrawal for cardiac reasons compared to furosemide. |
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AbstractList | Abstract Background Torasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs. Objective Evaluate the efficacy and safety of torasemide compared to furosemide in dogs with first occurrence of CHF caused by degenerative mitral valve disease (DMVD). Animals Three hundred and nineteen dogs with new onset CHF attributable to DMVD. Methods Double‐blinded randomized noninferiority study of PO torasemide vs furosemide in addition to standard CHF treatment. The primary efficacy criterion was decreased pulmonary edema and cough and no worsening of dyspnea or exercise tolerance at day 14. Secondary endpoints included clinical response at day 84 and time to death, euthanasia, or premature study withdrawal for cardiac reasons. Results Torasemide q24h (n = 161) was noninferior to furosemide q12h (n = 158); percentage of dogs meeting primary efficacy criterion at day 14 was similar between groups (torasemide, 74.4% [95% confidence interval (CI), 66.8%‐81.0%] vs. furosemide, 73.5% [95% CI, 65.7%‐80.4%]; risk ratio [RR], 1.01; 95% CI, 0.89‐1.15; P = .87). Efficacy at day 84 showed similar results (RR, 1.05; 95% CI, 0.88‐1.25; P = .6). Dogs receiving torasemide had a longer time to endpoint and were less than half as likely to experience death, euthanasia, or premature study withdrawal (hazard ratio, 0.36; 95% CI, 0.19‐0.65; P = .001) than dogs receiving furosemide at any time during the study. Conclusion and Clinical importance Torasemide was noninferior to furosemide as first line PO treatment for new onset CHF caused by DMVD. Torasemide significantly decreased risk of cardiac‐related death or premature study withdrawal for cardiac reasons compared to furosemide. BackgroundTorasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs.ObjectiveEvaluate the efficacy and safety of torasemide compared to furosemide in dogs with first occurrence of CHF caused by degenerative mitral valve disease (DMVD).AnimalsThree hundred and nineteen dogs with new onset CHF attributable to DMVD.MethodsDouble‐blinded randomized noninferiority study of PO torasemide vs furosemide in addition to standard CHF treatment. The primary efficacy criterion was decreased pulmonary edema and cough and no worsening of dyspnea or exercise tolerance at day 14. Secondary endpoints included clinical response at day 84 and time to death, euthanasia, or premature study withdrawal for cardiac reasons.ResultsTorasemide q24h (n = 161) was noninferior to furosemide q12h (n = 158); percentage of dogs meeting primary efficacy criterion at day 14 was similar between groups (torasemide, 74.4% [95% confidence interval (CI), 66.8%‐81.0%] vs. furosemide, 73.5% [95% CI, 65.7%‐80.4%]; risk ratio [RR], 1.01; 95% CI, 0.89‐1.15; P = .87). Efficacy at day 84 showed similar results (RR, 1.05; 95% CI, 0.88‐1.25; P = .6). Dogs receiving torasemide had a longer time to endpoint and were less than half as likely to experience death, euthanasia, or premature study withdrawal (hazard ratio, 0.36; 95% CI, 0.19‐0.65; P = .001) than dogs receiving furosemide at any time during the study.Conclusion and Clinical importanceTorasemide was noninferior to furosemide as first line PO treatment for new onset CHF caused by DMVD. Torasemide significantly decreased risk of cardiac‐related death or premature study withdrawal for cardiac reasons compared to furosemide. Torasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs. Evaluate the efficacy and safety of torasemide compared to furosemide in dogs with first occurrence of CHF caused by degenerative mitral valve disease (DMVD). Three hundred and nineteen dogs with new onset CHF attributable to DMVD. Double-blinded randomized noninferiority study of PO torasemide vs furosemide in addition to standard CHF treatment. The primary efficacy criterion was decreased pulmonary edema and cough and no worsening of dyspnea or exercise tolerance at day 14. Secondary endpoints included clinical response at day 84 and time to death, euthanasia, or premature study withdrawal for cardiac reasons. Torasemide q24h (n = 161) was noninferior to furosemide q12h (n = 158); percentage of dogs meeting primary efficacy criterion at day 14 was similar between groups (torasemide, 74.4% [95% confidence interval (CI), 66.8%-81.0%] vs. furosemide, 73.5% [95% CI, 65.7%-80.4%]; risk ratio [RR], 1.01; 95% CI, 0.89-1.15; P = .87). Efficacy at day 84 showed similar results (RR, 1.05; 95% CI, 0.88-1.25; P = .6). Dogs receiving torasemide had a longer time to endpoint and were less than half as likely to experience death, euthanasia, or premature study withdrawal (hazard ratio, 0.36; 95% CI, 0.19-0.65; P = .001) than dogs receiving furosemide at any time during the study. Torasemide was noninferior to furosemide as first line PO treatment for new onset CHF caused by DMVD. Torasemide significantly decreased risk of cardiac-related death or premature study withdrawal for cardiac reasons compared to furosemide. Background Torasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs. Objective Evaluate the efficacy and safety of torasemide compared to furosemide in dogs with first occurrence of CHF caused by degenerative mitral valve disease (DMVD). Animals Three hundred and nineteen dogs with new onset CHF attributable to DMVD. Methods Double‐blinded randomized noninferiority study of PO torasemide vs furosemide in addition to standard CHF treatment. The primary efficacy criterion was decreased pulmonary edema and cough and no worsening of dyspnea or exercise tolerance at day 14. Secondary endpoints included clinical response at day 84 and time to death, euthanasia, or premature study withdrawal for cardiac reasons. Results Torasemide q24h (n = 161) was noninferior to furosemide q12h (n = 158); percentage of dogs meeting primary efficacy criterion at day 14 was similar between groups (torasemide, 74.4% [95% confidence interval (CI), 66.8%‐81.0%] vs. furosemide, 73.5% [95% CI, 65.7%‐80.4%]; risk ratio [RR], 1.01; 95% CI, 0.89‐1.15; P = .87). Efficacy at day 84 showed similar results (RR, 1.05; 95% CI, 0.88‐1.25; P = .6). Dogs receiving torasemide had a longer time to endpoint and were less than half as likely to experience death, euthanasia, or premature study withdrawal (hazard ratio, 0.36; 95% CI, 0.19‐0.65; P = .001) than dogs receiving furosemide at any time during the study. Conclusion and Clinical importance Torasemide was noninferior to furosemide as first line PO treatment for new onset CHF caused by DMVD. Torasemide significantly decreased risk of cardiac‐related death or premature study withdrawal for cardiac reasons compared to furosemide. |
Author | Oyama, Mark A. Guillot, Emilie Besche, Beatrice Garelli‐Paar, Catherine Blondel, Thomas |
AuthorAffiliation | 1 Ceva Santé Animale Libourne France 2 Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine University of Pennsylvania Philadelphia Pennsylvania USA |
AuthorAffiliation_xml | – name: 2 Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine University of Pennsylvania Philadelphia Pennsylvania USA – name: 1 Ceva Santé Animale Libourne France |
Author_xml | – sequence: 1 givenname: Beatrice surname: Besche fullname: Besche, Beatrice email: beatrice.besche@ceva.com organization: Ceva Santé Animale – sequence: 2 givenname: Thomas surname: Blondel fullname: Blondel, Thomas organization: Ceva Santé Animale – sequence: 3 givenname: Emilie surname: Guillot fullname: Guillot, Emilie organization: Ceva Santé Animale – sequence: 4 givenname: Catherine surname: Garelli‐Paar fullname: Garelli‐Paar, Catherine organization: Ceva Santé Animale – sequence: 5 givenname: Mark A. orcidid: 0000-0002-5218-9226 surname: Oyama fullname: Oyama, Mark A. organization: University of Pennsylvania |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32767627$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_3390_ani12020209 crossref_primary_10_1111_jvim_16796 crossref_primary_10_3390_ani14050772 crossref_primary_10_1111_jvim_16500 crossref_primary_10_1111_jvp_13030 crossref_primary_10_1638_2021_0127 crossref_primary_10_1016_j_jvc_2021_11_003 crossref_primary_10_1111_jvim_16571 |
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Keywords | myxomatous mitral valve disease torsemide diuretics heart disease |
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Snippet | Background
Torasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs.
Objective
Evaluate the efficacy and safety of... Torasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs. Evaluate the efficacy and safety of torasemide compared to... Abstract Background Torasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs. Objective Evaluate the efficacy and... BackgroundTorasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs.ObjectiveEvaluate the efficacy and safety of... BACKGROUNDTorasemide is a potent loop diuretic with potential to treat congestive heart failure (CHF) in dogs. OBJECTIVEEvaluate the efficacy and safety of... |
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SubjectTerms | Ascites Cardiovascular disease Diuretics Dogs Drug dosages Dyspnea Edema Enzymes heart disease Heart failure Hospitalization Hypotheses myxomatous mitral valve disease SMALL ANIMAL torsemide |
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Title | Efficacy of oral torasemide in dogs with degenerative mitral valve disease and new onset congestive heart failure: The CARPODIEM study |
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