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. 2022 Jun;15(3):644-652.
doi: 10.1007/s12265-021-10173-1. Epub 2021 Oct 12.

Efficacy and Safety of Subcutaneous Infusion of Non-formulated Furosemide in Patients with Worsening Heart Failure: a Real-World Study

Jose Civera #  1   2 , Rafael de la Espriella #  1   2   3 , Raquel Heredia  1   2 , Gema Miñana  1   2   3 , Enrique Santas  1   2 , Adriana Conesa  1   2 , Anna Mollar  1   2 , Clara Sastre  1   2 , Ana Martínez  1   2 , Amparo Villaescusa  1   2 , Julio Núñez  4   5   6
Affiliations

Efficacy and Safety of Subcutaneous Infusion of Non-formulated Furosemide in Patients with Worsening Heart Failure: a Real-World Study

Jose Civera et al. J Cardiovasc Transl Res. 2022 Jun.

Abstract

We aimed to evaluate the efficacy (short-term changes in surrogates of decongestion) and safety following the ambulatory administration of subcutaneous furosemide (SCF) in patients with WHF. Fifty-five ambulatory patients were treated with SCF administered by an elastomeric pump for at least 72 h. Surrogates of congestion were assessed at baseline, 72 h, and 30 days. Spot urinary sodium (uNa+) was assessed at baseline, 24-48-72 h, and 30 days. The median (IQI) of NT-proBNP and uNa+ at baseline was 5218 pg/mL (2856-10878) and 68±3 mmol/L, respectively. Following administration of SCF (median dose of 100 mg/daily), we found a sustained increase in uNa+ during the first 72 h of treatment compared to baseline, paralleled with evidence of decongestion at 72 h, and 30 days. No significant safety concerns were observed. SCF was an effective and safe diuretic strategy for outpatient congestion management. Non-formulated subcutaneous furosemide in patients with WHF. Efficacy and safety.

Keywords: Diuretics; Fluid overload; Subcutaneous furosemide; Urinary sodium; Worsening heart failure.

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Conflict of interest statement

Rafael de la Espriella received board speaker fees and travel expenses from Novartis, Rovi, Pfizer, Daiichi Sankyo, Astra-Zeneca, NovoNordisk, Boehringer Ingelheim, Lilly. Gema Miñana received speaker fees and travel expenses from Abbott. Enrique Santas received board speaker fees and travel expenses from Novartis, Rovi, Pfizer, Daiichi Sankyo, Astra-Zeneca, NovoNordisk, Boehringer Ingelheim. Julio Núñez received board speaker fees and travel expenses from Novartis, Rovi, Pfizer, Daiichi Sankyo, Astra-Zeneca, NovoNordisk, Boehringer Ingelheim, Lilly. All other authors declare no competing interests.

Figures

None
Non-formulated subcutaneous furosemide in patients with WHF. Efficacy and safety.
Fig. 1
Fig. 1
Changes in clinical surrogates of congestion. a NYHA class. b Dyspnea VAS scale. c Pedal edema grading scale. d Weight. α, changes at 72 h vs. baseline. δ, changes at FU visit vs. baseline. NYHA, New York Heart Association; VAS, visual analog scale
Fig. 2
Fig. 2
Changes in biomarkers of congestion. a NT-proBNP. b CA125. α, changes at 72 h vs. baseline. δ, changes at FU visit vs. baseline. lnCA125, natural logarithm of carbohydrate antigen 125; FU, follow-up; lnNT-proBNP, natural logarithm of amino-terminal pro-brain natriuretic peptide
Fig. 3
Fig. 3
Longitudinal trajectory of uNa+ during follow-up. α, changes at 24 h vs. baseline. β, changes at 48 h vs. baseline. γ, changes at 72 h vs. baseline. δ, changes at FU visit vs. baseline. FU, follow-up; uNa+, urinary sodium
Fig. 4
Fig. 4
Safety parameters. a Systolic blood pressure. b Estimated glomerular filtration rate. c Serum potassium. d Serum sodium. α, changes at 72 h vs baseline. δ, changes at FU visit vs baseline. eGFR, estimated glomerular filtration rate; FU, follow-up; SBP, systolic blood pressure
See this image and copyright information in PMC

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