Abstract | BACKGROUND AND AIMS: METHODS AND RESULTS: A multi-centre, open-label, randomized, and active-comparator trial. Patients were randomized to dapagliflozin 10 mg once daily or metolazone 5-10 mg once daily for a 3-day treatment period, with follow-up for primary and secondary endpoints until day 5 (96 h). The primary endpoint was a diuretic effect, assessed by change in weight (kg). Secondary endpoints included a change in pulmonary congestion (lung ultrasound), loop diuretic efficiency (weight change per 40 mg of furosemide), and a volume assessment score. 61 patients were randomized. The mean (±standard deviation) cumulative dose of furosemide at 96 h was 977 (±492) mg in the dapagliflozin group and 704 (±428) mg in patients assigned to metolazone. The mean (±standard deviation) decrease in weight at 96 h was 3.0 (2.5) kg with dapagliflozin compared to 3.6 (2.0) kg with metolazone [mean difference 0.65, 95% confidence interval (CI) -0.12,1.41 kg; P = 0.11]. Loop diuretic efficiency was less with dapagliflozin than with metolazone [mean 0.15 (0.12) vs. 0.25 (0.19); difference -0.08, 95% CI -0.17,0.01 kg; P = 0.10]. Changes in pulmonary congestion and volume assessment score were similar between treatments. Decreases in plasma sodium and potassium and increases in urea and creatinine were smaller with dapagliflozin than with metolazone. Serious adverse events were similar between treatments. CONCLUSION: TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04860011.
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Authors | Su Ern Yeoh, Joanna Osmanska, Mark C Petrie, Katriona J M Brooksbank, Andrew L Clark, Kieran F Docherty, Paul W X Foley, Kaushik Guha, Crawford A Halliday, Pardeep S Jhund, Paul R Kalra, Gemma McKinley, Ninian N Lang, Matthew M Y Lee, Alex McConnachie, James J McDermott, Elke Platz, Peter Sartipy, Alison Seed, Bethany Stanley, Robin A P Weir, Paul Welsh, John J V McMurray, Ross T Campbell |
Journal | European heart journal
(Eur Heart J)
Vol. 44
Issue 31
Pg. 2966-2977
(08 14 2023)
ISSN: 1522-9645 [Electronic] England |
PMID | 37210742
(Publication Type: Randomized Controlled Trial, Multicenter Study, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. |
Chemical References |
- Metolazone
- Sodium Potassium Chloride Symporter Inhibitors
- Furosemide
- Diuretics
- Sodium
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Topics |
- Humans
- Metolazone
(therapeutic use, adverse effects)
- Sodium Potassium Chloride Symporter Inhibitors
(therapeutic use)
- Furosemide
(therapeutic use)
- Heart Failure
(drug therapy, chemically induced)
- Diuretics
(therapeutic use)
- Sodium
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