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. 2020 Sep;34(5):1746-1758.
doi: 10.1111/jvim.15864. Epub 2020 Aug 7.

Efficacy of oral torasemide in dogs with degenerative mitral valve disease and new onset congestive heart failure: The CARPODIEM study

Beatrice Besche  1 , Thomas Blondel  1 , Emilie Guillot  1 , Catherine Garelli-Paar  1 , Mark A Oyama  2
Affiliations

Efficacy of oral torasemide in dogs with degenerative mitral valve disease and new onset congestive heart failure: The CARPODIEM study

Beatrice Besche et al. J Vet Intern Med. 2020 Sep.

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.

Keywords: diuretics; heart disease; myxomatous mitral valve disease; torsemide.

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Conflict of interest statement

Beatrice Besche, Thomas Blondel, Emilie Guillot, and Cathering Garelli‐Paar are employees of Ceva Santé Animale. Mark A. Oyama has received research funding, reimbursement for travel, honoraria for speaking and preparation of educational materials, and consulting fees from Ceva Santé Animale within the past 5 years.

Figures

FIGURE 1
FIGURE 1
Flowchart of 321 dogs enrolled in the study
FIGURE 2
FIGURE 2
Kaplan‐Meier survival curves displaying the probability of cardiac death or euthanasia or premature study withdrawal because of cardiac reasons in the torasemide group (green solid line) vs the furosemide group (yellow dotted line). Cross marks represent censored observations
FIGURE 3
FIGURE 3
Kaplan‐Meier survival curves displaying the probability of all‐cause mortality in the torasemide group (green solid line) vs the furosemide group (yellow dotted line). Cross marks represent censored observations
See this image and copyright information in PMC

References

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