Digoxin Cuts 18% Composite Risk in Rheumatic Heart Disease, With 1.1% Toxicity Discontinuation
Updated
Updated · Medical Dialogues · May 22
Digoxin Cuts 18% Composite Risk in Rheumatic Heart Disease, With 1.1% Toxicity Discontinuation
2 articles · Updated · Medical Dialogues · May 22
JAMA data presented at ESC Heart Failure 2026 showed symptomatic rheumatic heart disease patients on digoxin had a 31.4% rate of death or new/worsening heart failure, versus 35.5% with placebo.
That translated into an 18% lower risk for the primary composite outcome, driven mainly by fewer episodes of new-onset or worsening heart failure.
All-cause mortality alone was nearly unchanged—10.0% with digoxin and 10.4% with placebo—while most worsening heart failure events were treated with oral or IV diuretics without hospitalization.
The study population was high risk: most had multivalve disease, 85% had moderate to severe mitral stenosis, 70% had atrial fibrillation, and most were NYHA class II to IV.
Safety appeared favorable, with permanent discontinuation for suspected digoxin toxicity occurring in just 1.1% of treated patients.
With no change in death rates, is digoxin's benefit for heart failure enough to alter global RHD care?
Why is a century-old drug now the new hope for a neglected heart disease affecting millions?