A large-scale study by the Hannover Medical School (MHH) proves the efficacy and safety of digitoxin in advanced heart failure (HFrEF). The DIGIT-HF study, which was conducted over ten years with more than 1,200 participants, shows that cardiac glycoside significantly reduces mortality and hospitalizations.

Heart failure, in which the heart does not pump enough blood, affects about four million people in Germany and leads to symptoms such as shortness of breath, limited exercise capacity and water retention. Although digitalis preparations such as digitoxin have been used for over 200 years, there has been a lack of scientifically sound proof of their effectiveness. Under the direction of Professor Dr. Johann Bauersachs and Professor Dr. Udo Bavendiek, the multicenter study with over 50 clinics in Germany, Austria and Serbia investigated the effect of digitoxin as an adjunctive therapy in HFrEF patients. The findings, published in the New England Journal of Medicine and presented at the European Society of Cardiology Congress in Madrid in August 2025, confirm significant benefits.

The study shows that digitoxin reduces mortality and hospitalizations in patients who are already being treated with standard therapies such as beta-blockers, ACE inhibitors or SGLT-2 inhibitors. It is particularly advantageous that digitoxin is also safe in cases of impaired kidney function, as it is excreted via the liver and intestines, unlike digoxin. With a dosage of 0.07 milligrams per day or less, safety was confirmed, and previous concerns about potential risks were refuted. In addition, Digitoxin is extremely cost-effective as a generic drug, which makes it an attractive option in the healthcare system.

The study, which is funded with around seven million euros by the German Federal Ministry of Research, Technology and Space and other foundations, could establish digitoxin as the standard therapy for HFrEF. It offers new hope for patients with advanced heart failure and shows that the drug also effectively controls heart rate in atrial fibrillation when other treatments are inadequate.

Original Paper:

Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction | New England Journal of Medicine

Editor: X-Press Journalistenbüro GbR

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