At-home diuretic pump cuts hospital stays for heart failure patients in trial

Overview

Updated 2 hours ago

Patients hospitalized with heart failure went home an average of five days early and finished their congestion treatment from an abdominal pump delivering the same diuretic normally given intravenously. The randomized trial behind it was published October 14 in the Journal of the American College of Cardiology, one of cardiology's flagship journals.

The approach trades a hospital bed for a wearable device that patients or caregivers operate, delivering roughly 900 mg of subcutaneous furosemide per treatment course, a hospital-equivalent dose. The headline result: four more days alive and out of the hospital in the month after randomization. The open question: the at-home group had more heart failure readmissions, and that imbalance will shape how payers and guideline writers judge the pathway.

Why it matters

If this pathway becomes standard care, heart failure congestion treatment moves out of hospital beds, cutting per-episode costs and freeing capacity.

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Key Indicators

4.0 days

Extra days alive and out of hospital at 30 days

Primary endpoint of SUBCUT HF II, favoring the at-home early-discharge group (P < 0.001).

5.5 days

Cut from average index hospital stay

Index hospitalization fell from a mean of 11.0 to 5.6 days for early-discharge patients.

172

Patients enrolled across 20 UK NHS hospitals

92 assigned to early discharge with home pumps, 80 to usual inpatient care.

25%

Serious adverse events in the at-home group

Comparable to 23% in usual care; no serious device-related events occurred.

Voices

Curated perspectives — historical figures and your fellow readers.

Ever wondered what historical figures would say about today's headlines?

People Involved

Pieter Muntendam

Founder, President and CEO of SQ Innovation

Leading commercialization of Lasix ONYU after FDA approval

Ross T. Campbell

Principal Investigator, Glasgow Cardiovascular Research Centre

Co-led SUBCUT HF II across 20 NHS hospitals

Mark C. Petrie

Principal Investigator, Glasgow Cardiovascular Research Centre

Co-led SUBCUT HF II; emphasizing patient selection for home discharge

Organizations Involved

SQ Innovation

Medical device and pharmaceutical company

Developer and manufacturer of Lasix ONYU

Developed Lasix ONYU, a wearable pump delivering subcutaneous furosemide for heart failure edema.

University of Glasgow

University and research institution

Trial co-sponsor through the Glasgow Cardiovascular Research Centre

Co-sponsored SUBCUT HF II and hosted its principal investigators.

NHS Greater Glasgow and Clyde Health Board

National Health Service health board

Trial co-sponsor

Co-sponsored SUBCUT HF II with the University of Glasgow.

Timeline

2024 October 2026

4 events Latest: Yesterday

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October 2026
Full trial results published in JACC
Latest Publication

Complete SUBCUT HF II results published, showing four more days alive and out of hospital at 30 days.
Yesterday
May 2026
SUBCUT HF II results presented in Barcelona
Study Presentation

Topline results shown in the Hottest Trials session at the Heart Failure Association congress of the European Society of Cardiology.
May 9th, 2026
October 2025
FDA approves Lasix ONYU
Regulatory Approval

US Food and Drug Administration clears the wearable pump delivering 80 mg subcutaneous furosemide over five hours.
October 2025
2024
Pilot trial supports subcutaneous furosemide
Study

AT HOME-HF pilot finds subcutaneous furosemide safely augments weight loss in congested heart failure patients.
2024

Scenarios

At-home subcutaneous diuresis becomes standard heart failure care

Uncertain Resolves by End of 2028

Discussed by: Trial investigators at the University of Glasgow and SQ Innovation leadership

If payers and guideline bodies accept the SUBCUT HF II evidence, hospitals adopt early supported discharge with wearable furosemide pumps as a routine pathway for stable congested heart failure patients. The UK's National Institute for Health and Care Excellence (NICE) and the US Centers for Medicare and Medicaid Services (CMS) would need to approve reimbursement, and the higher heart failure readmission rate would have to be accepted against the savings in beds and costs.

Readmission imbalance prompts regulatory caution

Possible Resolves by End of 2027

Discussed by: The published trial results and regulators reviewing them

At 60 days, early-discharge patients had more heart failure readmissions: 13 (14%) versus 5 (6%), an odds ratio near 2.45 that did not reach statistical significance. Regulators could still flag the imbalance and request a larger confirmatory trial or restrict at-home use to low-risk patients. That would slow adoption without stopping it.

Lasix ONYU expands to new markets before US reimbursement settles

Likely Resolves by Q2 2028

Discussed by: SQ Innovation

With FDA approval already in hand and positive trial data now published, the company could file for European or UK marketing authorization while US payer decisions and guideline updates take shape. Success depends on regulators outside the US weighing the readmission signal differently than their American counterparts.

Historical Context

3 moments from history that rhyme with this story — and how they unfolded.

1970s

Home peritoneal dialysis (1970s)

Chronic kidney disease patients who once required thrice-weekly dialysis in a clinic learned to run peritoneal dialysis at home with portable equipment, exchanging fluid through a catheter in their abdomen. The approach matched survival outcomes of in-center hemodialysis.

Then

Home dialysis became a standard option, cutting clinic capacity needs and letting patients dialyze overnight.

Now

It established the template for moving a procedure-intensive chronic therapy out of the hospital.

Why this matters now

The furosemide pump applies the same logic to a common acute heart failure treatment that most patients still receive in a hospital bed.

November 2020

CMS Acute Hospital Care at Home (2020)

The US Centers for Medicare and Medicaid Services (CMS) waived rules so hospitals could treat selected acute patients at home, including those with heart failure, instead of admitting them. The pandemic prompted the waiver.

Then

Hundreds of hospitals used the waiver, and study data showed comparable outcomes with fewer complications.

Now

Hospital-at-home shifted from a niche experiment to a reimbursed care model, though it remains limited to stable, carefully selected patients.

Why this matters now

SUBCUT HF II tests the same idea with a specific device rather than a general waiver, and it quantifies the bed-day savings a hospital-at-home program produces.

1978-2000s

Insulin pumps for diabetes (1978-2000s)

Insulin delivery moved from hospital-managed injections to patient-operated wearable pumps that administer precise doses around the clock. Early devices were bulky and prone to failure; successive generations became smaller and safer.

Then

Continuous subcutaneous insulin infusion became standard for type 1 diabetes, letting patients manage a demanding therapy outside clinics.

Now

It proved patients can safely self-manage complex drug delivery when the device is designed for it.

Why this matters now

Lasix ONYU relies on the same premise, a wearable pump a patient operates at home, applied to intravenous diuretics that have stayed hospital-bound.