Evidence map›Paper›PMID 39520561›Full record

SynthesisEuropean heart journal. Cardiovascular pharmacotherapy2025

Subcutaneous furosemide in heart failure: a systematic review.

Joanna Osmanska, Mark C Petrie, Kieran F Docherty, Matthew M Y Lee, John J V McMurray, Ross T Campbell

Abstract readSystematic Review
In one paragraph

Synthesis in European heart journal. Cardiovascular pharmacotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Joanna OsmanskaSchool of Cardiovascular and Metabolic Health, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow 126 University Place, Glasgow G12 8TA, UK.ORCID 0000-0002-8419-0838
Mark C PetrieSchool of Cardiovascular and Metabolic Health, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow 126 University Place, Glasgow G12 8TA, UK.ORCID 0000-0002-6333-9496
Kieran F DochertySchool of Cardiovascular and Metabolic Health, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow 126 University Place, Glasgow G12 8TA, UK.ORCID 0000-0002-5446-9969
Matthew M Y LeeSchool of Cardiovascular and Metabolic Health, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow 126 University Place, Glasgow G12 8TA, UK.ORCID 0000-0001-9213-2067
John J V McMurraySchool of Cardiovascular and Metabolic Health, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow 126 University Place, Glasgow G12 8TA, UK.ORCID 0000-0002-6317-3975
Ross T CampbellSchool of Cardiovascular and Metabolic Health, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow 126 University Place, Glasgow G12 8TA, UK.ORCID 0000-0002-0050-2129

Funding

British Heart Foundation Centre of Research Excellence RE/18/6/34217
6 · The paper itself

Abstract

BACKGROUND AND

aimIntravenous loop diuretics are the primary treatment for congestion in patients with decompensated heart failure (HF). Furosemide is the most commonly used loop diuretic and is licensed for administration either orally, intramuscularly or intravenously but not subcutaneously. Recently developed, pH-neutral, concentrated, and 'skin-friendly' preparations of furosemide have been developed which allow subcutaneous administration. In this systematic review, we summarize and critically appraise the current evidence for subcutaneous furosemide in patients with HF. METHODS AND

resultsThe electronic databases MEDLINE, EMBASE, the Cochrane Library, and ClinicalTrials.gov registry were searched up to 30 September 2024. Of the 17 studies identified, 5 were randomized controlled trials (RCTs), 2 were non-randomized controlled studies, 3 were prospective observational cohort studies, and 7 were retrospective observational studies.All RCTs utilized novel pH-neutral, subcutaneous preparations of furosemide. Bioavailability of novel subcutaneous preparations were similar to intravenous furosemide 10 mg/mL: 99.7% for an 8 mg/mL preparation and 112% for a 30 mg/mL preparation. Natriuresis and diuresis were also similar with novel subcutaneous and conventional intravenous furosemide. Adverse events related to novel preparations included infusion site pain or discomfort, localized skin erythema and minimal swelling. All studies of subcutaneous conventional furosemide were non-randomized with very few data regarding bioavailability or diuretic and natriuretic effect. Subcutaneous conventional furosemide was associated with substantial skin irritation (affecting 3-23% of patients), and skin infections requiring treatment with antibiotics (3-17%).

conclusionNovel, pH-neutral preparations of subcutaneous furosemide achieved similar diuresis, natriuresis, and bioavailability to intravenous furosemide, and were well tolerated. Novel preparations may be a treatment option for patients with HF.

Indexed as

DiuresisFurosemideHeart FailureSodium Potassium Chloride Symporter InhibitorsBiological AvailabilityHumansInjections, SubcutaneousNatriuresisTreatment OutcomeFurosemideSodium Potassium Chloride Symporter InhibitorsCongestionDiureticsFurosemideHeart failureSubcutaneous

Identifiers

PMID39520561
PMCPMC11805693

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.