1421-P: Subcutaneous (SC) Furosemide (FUR) Use for Fluid Overload in Persons Living with Diabetes Mellitus

Introduction and Objective: Heart failure (HF) is leading cause of hospitalizations in persons living with DM (PWD), prompting ADA’s 2025 SOC HF screening guidance. Furoscix is 80mg/10mL buffered formulation of furosemide (FUR) for self-administered, SC delivery with equivalent bioavailability to IV FUR. AT HOME-HF was open-label, randomized pilot study of SC FUR in outpatients with fluid overload (FO) who required augmented diuretic therapy. Objective of post-hoc analysis: stratify 30-day hospitalization rates by DM status. Methods: HF patients with signs and symptoms of FO were randomized 2:1 to SC FUR (once or twice daily) or usual care (UC) of oral diuretic augmentation. Both SC FUR dosing and UC regimen were determined by the investigators based on clinical response. Results descriptive only. Results: Of 51 HF patients, 28 (57%) had concomitant DM; 19 (56%) in SC FUR and 9 (53%) in UC. 90% of SC FUR doses were administered within first 7 days; 97% once-daily. HF hospitalization occurred in 11% and 22% of PWD in SC FUR and UC groups, respectively (Table 1). In those PWD hospitalized, mean days until hospitalization was 17 for SC FUR and 4 for UC. Conclusion: SC FUR demonstrated lower rates of, and longer times until hospitalization vs. UC regardless of DM. Larger studies are warranted. Clinicians who manage PWD should be aware of HF risk and possibility of SC FUR to reduce HF hospitalizations. Disclosure A. Ahuja: Employee; Current; MannKind Corporation. Stock/Shareholder; Current; MannKind Corporation. Employee; Ended; Idorsia Pharmaceuticals Ltd., Kardigan. Stock/Shareholder; Current; Kardigan. P. Kamineni: Employee; Current; scPharmaceuticals, Inc., MannKind Corporation. K. Luepke: Employee; Current; scPharmaceuticals, Inc., MannKind Corporation. B. Cornelius: Employee; Ended; Idorsia Pharmaceuticals Ltd., Kardigan. Stock/Shareholder; Current; Kardigan. Employee; Current; MannKind Corporation. Stock/Shareholder; Current; MannKind Corporation. M. Goodwin: Employee; Current; scPharmaceuticals, Inc., MannKind Corporation. J. Mohr: Employee; Current; MannKind Corporation, scPharmaceuticals, Inc.