The Unmet Need in Heart Failure**
Heart failure affects 5.7 million Americans annually, with the number continuing to rise. It results in over 1 million hospitalizations and 700,000 emergency room visits annually at costs exceeding $10 billion.
The majority of the heart failure patients are in the hospital for one reason – to reduce fluid overload, through a process called diuresis, or increased urine output. The average heart failure patient loses over 2.2 gallons (8.4 liter) of body fluid during standard treatment. Water is heavy and they lose on average over 15 pounds over the 5-6 days of hospital stay. This marked increase of urine output is achieved by giving drugs known as diuretics.
Heart Failure Treatment: Proven but Costly
Furosemide is the diuretic most often used to treat fluid overload caused by heart failure. Developed in the 1960s and commercialized under the brand name Lasix®, furosemide is available in oral form to prevent fluid build-up and in intravenous (IV) form to remove excess fluid when oral medication alone is insufficient.
The term clinical diuresis is used for medication induced increase in urine output in a clinical setting, such as an emergency room, observation unit or hospital. Clinical diuresis is expensive and in most cases avoidable. The cost is in the services. Costs range from $4,000 to over $8,000 per gallon of urine – on average $17,654 per hospital admission.
Clinical diuresis is avoidable through early recognition and treatment. Fluid build-up is a relatively slow process which may take up to three weeks. The patient slowly recognizes the increase in symptoms and body weight. This creates a window for treatment with increased oral or subcutaneous furosemide** to reverse the course and get back to a normal fluid balance. Careful monitoring of body weight and other parameters helps to identify the beginning of fluid overload early and increase the window for treatment. This can be illustrated as follows.
Standard of Care in Decompensated HF
The majority of patients with heart failure do not receive any advanced procedure while in the hospital. They are just there to receive intravenous furosemide to reduce fluid overload. It is estimated that about half the patients could finish the treatment at home after a short 1-2 day stay.
Transforming the Treatment Paradigm
Furosemide delivered subcutaneously—just under the skin instead of through an IV— would offer a new option to clinicians treating patients with heart failure. It has the potential to keep patients out of the hospital, facilitate early discharge and prevent readmissions, while significantly reducing risks and costs. It represents the first major treatment advance for fluid overload in heart failure in more than half a century.
Learn more about how scPharmaceuticals is developing subcutaneous furosemide in combination with its proprietary sc2Wear™ Infusor.
**CAUTION: Investigational Product – Limited by Federal Law to Investigational Use.