6/28/23, 12:11 AM CLOROTIC Pathway Feedback Search Clinical Topics Home Studies CLOROTIC CLOROTIC Disease Heart failure Trial question What is the effect of hydrochlorothiazide addition to loop diuretic therapy in patients with acute HF? Study design Multi-center Double blinded RCT Population Characteristics of study participants 48.0% female N = 230 52.0% male 230 patients (111 female, 119 male) Inclusion criteria: hospitalized adult patients with acute decompensated HF Key exclusion criteria: unstable on admission; treatment with inotropic agents; or any thiazide diuretic during the month before admission Interventions N=114 hydrochlorothiazide (at a dose of 25-100 mg/day, adjusted according to GFR, plus intravenous furosemide regimen) N=116 placebo (matching placebo plus intravenous furosemide regimen) Primary outcome Weight reduction at 72 hours 2.3 kg 2.3 https://web.pathway.md/studies/recSbGBntcqPrJOqR 1/2 6/28/23, 12:11 AM CLOROTIC Pathway 1.7 kg 1.5 1.1 kg 0.6 kg Significant increase 0.0 kg Hydrochlorothiazide Placebo Significant increase in weight reduction at 72 hours (2.3 kg vs. 1.5 kg; AD 1.14 kg, 95% CI 0.42 to 1.84) Secondary outcomes No significant difference in patient-reported dyspnea using area under curve for the VAS at 72 hours (960 vs. 720; AD 240, 95% CI -436.98 to 916.98) Significant increase in weight reduction at 96 hours (2.5 kg vs. 1.5 kg; AD 1.57 kg, 95% CI 0.76 to 2.35) No significant difference in patient-reported dyspnea using area under curve for the VAS at 96 hours (1500 vs. 1320; AD 180, 95% CI -389.96 to 749.96) Safety outcomes No significant difference in reduction in eGFR > 50%. Significant differences in impaired renal function (46.5% vs. 17.2%), elevation in creatinine > 26.5 mol/L (46.5% vs. 17.2%). Conclusion In hospitalized adult patients with acute decompensated HF, hydrochlorothiazide was superior to placebo with respect to weight reduction at 72 hours. Reference Joan Carles Trull s, Jos Luis Morales-Rull, Jes s Casado et al. Combining loop with thiazide diuretics for decompensated heart failure: the CLOROTIC trial. Eur Heart J. 2022 Nov 24;ehac689. Open reference URL https://web.pathway.md/studies/recSbGBntcqPrJOqR 2/2