Promising news for digitalis

The new look at spironolactone may change the way doctors think about digitalis . . . again, says lead RALES researcher Bertram Pitt, MD, of the University of Michigan.

In 1997, the Digitalis Investigation Group (DIG) found digoxin reduced congestive heart failure hospitalization by 28% and lowered general hospitalizations by 6%. Although patients on digoxin could improve their exercise tolerance, DIG found no change in survival between patients who took digoxin and those who did not.

That finding may change, however: Pitt notes that when used with spironolactone, digitalis may have a synergistic effect in CHF patients. He notes that some of the fatalities that occurred in the DIG trial among the participants receiving digitalis were due to arrhythmia.

"Spironolactone may be working to lessen these risks, and it looks like you would get increased survivability," he says, noting more studies of this effect are being planned.