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A novel opportunity to improve heart failure care: focusing on subcutaneous furosemide

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Abstract

The prevalence of heart failure (HF) continues to rise in developed nations. Symptomatic congestion is the most common reason for patients to seek medical attention, and management often requires intravenous (IV) diuretic administration in the hospital setting. Typically, the number of admissions increases as the disease progresses, not only impacting patient survival and quality of life but also driving up healthcare expenditures. pH-neutral furosemide delivered subcutaneously using a proprietary, single-use infusor system (Furoscix) has a tremendous potential to transition in-hospital decongestive therapy to the outpatient setting or to the patient’s home. This review is aimed at providing an overview of the pharmacodynamic and pharmacokinetic profile of the novel pH-neutral furosemide in addition to the most recent clinical trials demonstrating its benefit when used in the home setting. Given the newest data and approval by the Food and Drug Administration in the US, it has the potential to revolutionize the care of patients with decompensated HF. Undoubtedly, it will lead to improved quality of life as well as significantly reduced healthcare costs related to hospital admissions.

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Abbreviations

HF:

Heart failure

ADHF:

Acute decompensated heart failure

ED:

Emergency department

CVD:

Cardiovascular disease

ECF:

Extracellular fluid

IV:

Intravenous

SC:

Subcutaneous

NYHA:

New York Heart Association

KCCQ-12:

Kansas City Cardiomyopathy Questionnaire

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Authors and Affiliations

  1. Department of Medicine, Avera Health, Sioux Falls, SD, 57105, USA

    Wahab J. Khan

  2. Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, 55455, USA

    Jose Arriola-Montenegro, Melinda S. Mutschler & Tamas Alexy

  3. Division of Cardiovascular Medicine, Cone Health, Greensboro, NC, 27401, USA

    Daniel Bensimhon

  4. Division of Cardiology, 1st Department of Medicine, Medical School, University of Pecs, 7624, Pecs, Hungary

    Robert Halmosi & Kalman Toth

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  1. Wahab J. Khan
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Contributions

WJK, JA, MSM, and RH participated in writing various sections of the manuscript. DB, KT, and TA wrote portions of the paper, edited and integrated the sections, and reviewed the final manuscript.

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Correspondence to Tamas Alexy.

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DB and TA serve on the speakers’ bureau and as consultants for scPharmaceuticals. TA is also on the speakers’ bureau for Abbott, Inc. All other authors declare no competing interests.

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Khan, W.J., Arriola-Montenegro, J., Mutschler, M.S. et al. A novel opportunity to improve heart failure care: focusing on subcutaneous furosemide. Heart Fail Rev 28, 1315–1323 (2023). https://doi.org/10.1007/s10741-023-10331-4

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