Dapagliflozin appears to be no more effective than the 'thiazide-like' diuretic metolazone at improving pulmonary congestion and fluid status in patients with acute heart failure, suggests a new randomized trial.
The multicenter trial randomly assigned 61 patients with AHF to receive dapagliflozin at a fixed dose of 10 mg once daily or metolazone 5 mg or 10 mg once daily for 3 days of treatment on an open-label basis.
Their median age was 79 and 54% were women; 44% had HF with reduced ejection fraction. Their mean glomerular filtration rate was below 30 mL/min/1.73 mThe mean cumulative furosemide dose was significantly higher among the dapagliflozin group's 31 patients, 976 mg vs 704 mg for the 30 on acetazolamide , 96 hours after the start of randomized therapy.
The mean decrease in weight at 96 hours, the primary endpoint, reached 3 kg on dapagliflozin compared to 3.6 kg with metolazone , a difference that fell short of significance.
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