AzTrials
AzTrials

Acute Heart FailureGENTLE-UFNCT02769351

Global rEgistry on decongestioN Therapy Using Less invasivE UltraFiltration

An observational study of Acute Heart Failure and Cardiac Decompensation, run by Fresenius Medical Care Deutschland GmbH at 19 sites in 3 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

In patients with advanced volume overload, minimally invasive ultrafiltration treatment in the acute phase can have a positive effect on clinical outcome. The aim is to collect treatment data in the context of a prospective registry of the safety and performance of minimally invasive ultrafiltration. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
periph. minimal invasive ultrafiltration
Type of treatment
Medical device
How many people
104 participants
Where
19 sitesin 3 countries
Study dates
3 Dec 2015to 4 Mar 2019
How long will I take part?
12 Months
Phase
Observational
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients treated with minimally invasive ultrafiltration in support of diuretic drug therapy in the acute phase of volume overload.

Who may be able to join

  • ≥18 years
  • Inpatient-treated patients with acute volume overload, preferably in association with cardiac decompensation with signs of incipient diuretic resistance (lack of increase in urine output despite significant escalation of diuretic therapy; e.g. ≥80 mg furosemide / 24 h or less than 1375 mL urine output/40 mg furosemide per 24 h or equivalent dose of other loop diuretics [established clinically or from the medical history])
  • New York Association Functional Class (NYHA) III-IV at inclusion
  • Systolic or diastolic cardiac dysfunction (HF-REF or HF-PEF)
  • Adequate venous access (preferably peripheral arm vein) allowing a flow rate ≥ 60 mL / min
  • Written consent to the use of data in the registry (where necessary, by a legal guardian).

Who cannot join

  • Contraindication to anticoagulation (e.g. known heparin-induced thrombocytopenia, severe bleeding)
  • Terminal renal failure (stage V, GFR <15 mL)
  • Cardiogenic shock, e.g. in association with acute coronary syndrome (ACS)
  • Other diseases or factors that, in the study doctor's opinion, constitute a potential contraindication to ultrafiltration
  • Pregnant women, women in labour, breast-feeding women or women of childbearing potential, who are without adequate contraception or are planning a family. NB: a pregnancy test is performed systematically in women of childbearing age and the patient is not included in the event of pregnancy (positive test). It is absolutely essential that women, who have a negative test and who are included in the study, have an effective contraception.

Trial locations and contacts

19 sites in 3 countries.

19 sites in 3 countries

Germany11 sites
  • Uniklinik RWTH Aachen

    Aachen, North Rhine-Westphalia, 52074

  • Helios Klinik Attendorn

    Attendorn, North Rhine-Westphalia, 57439

  • Helios Klinikum Berlin Buch

    Berlin, 13125

  • Städtisches Klinikum Braunschweig

    Braunschweig, Lower Saxony, 38126

  • Helios Klinikum Duisburg

    Duisburg, North Rhine-Westphalia, 47053

  • HELIOS Klinikum Erfurt

    Erfurt, Thuringia, 99089

  • Universitätsklinikum Heidelberg

    Heidelberg, Baden-Wurttemberg, 69120

  • Helios Klinikum Hildesheim

    Hildesheim, Lower Saxony, 31135

  • Helios Klinik für Herzchirurgie GmbH Karlsruhe

    Karlsruhe, Baden-Wurttemberg, 76185

  • Universitätsklinikum Mannheim

    Mannheim, Baden-Wurttemberg, 68167

  • Klinikum Stuttgart

    Stuttgart, Baden-Wurttemberg, 70174

Other trials in Germany

Sweden6 sites
  • Falun Hospital

    Falun, 79182

  • SUS Skanes University Hosptal

    Malmö, 20502

  • University Hospital Örebro

    Örebro, 70185

  • Karolinska University Hospital

    Stockholm, 17176

  • Danderyd University Hospital

    Stockholm, 18288

  • Uppsala University Hospital

    Uppsala, 75185

Other trials in Sweden

Switzerland2 sites
  • Kantonsspital Aarau

    Aarau, 5001

  • UniversitätsSpital Zurich

    Zurich, 8091

Other trials in Switzerland

About this study

Official title: A Multicentre, Prospective Registry to Evaluate the Safety and Efficacy of Minimally Invasive Ultrafiltration Treatment and Its Effect on Symptoms and Rehospitalisation in Patients With Advanced Volume Overload

In patients with advanced volume overload, minimally invasive ultrafiltration treatment in the acute phase can have a positive effect on clinical outcome. The aim is to collect treatment data in the context of a prospective registry of the safety and performance of minimally invasive ultrafiltration. The data will be recorded via an electronic case report form (eCRF); the eCRF runs on a server located in Germany and complies with current data protection regulations. It is intended to include about 300-500 patients with advanced volume overload at a minimum of 10 sites. In addition, data on a disease management programme (in-body measurement and home monitoring) will be recorded in up to 40 of these patients. The treatment data from each patient will be recorded over 12 months. An interim analysis will be performed after 150 patients have been observed for 6 months. The knowledge about ultrafiltration in volume overload obtained from the registry, in some cases in combination with a disease management programme, is intended to improve the body of evidence. In addition, the data will be used for hypothesis generation.

Read the detailed description

There may be various reasons why an increased accumulation of fluid occurs in tissue. The most common causes include heart failure, kidney failure or cirrhosis of the liver. In rare cases, oedema can develop following septicaemia. The usual treatment of oedema involves diuretics, i.e. water tablets, which remove excess fluid from the body and which can be administered either orally or intravenously. For some years now, it has also been possible to use ultrafiltration to treat oedema. This involves filtering and removing excess fluid from the blood. This individual method enables a precisely defined amount of fluid to be withdrawn. Access to the blood circulation is usually via a central venous catheter, as in acute dialysis. Current international treatment guidelines recommend that consideration should be given to ultrafiltration therapy in the context of treatment of diuretic-resistant volume overload (e.g. second- or third-line therapy for acute decompensated heart failure). There are, however, to date no clinical data on a combined treatment regimen of diuretics and supportive ultrafiltration. Accordingly, ultrafiltration may be included in clinical guidelines either only with a low level of evidence (e.g. IIb in the ACCF/AHA guidelines) or not at all (ESC guidelines). The main reasons for the limited body of evidence for ultrafiltration are, on the one hand, the invasive nature of the usual procedures (these usually require the insertion of a central venous catheter) and structural barriers in the health system (ultrafiltration is normally offered by nephrologists and not by cardiologists). With an increasing clinical need and limited medical alternatives, particularly in view of the frequently occurring diuretic resistance in heart failure, there is an urgent medical need to fill this gap in evaluation evidence. In the context of the registry, the CHIARA system, a minimally invasive (i.e. via a peripheral venous access) extracorporeal ultrafiltration system, is used for the treatment of decompensated volume overload. The CHIARA system has a CE mark for the intended purpose of ultrafiltration of the blood of patients suffering from heart failure, acute or chronic renal failure or excess body fluid. It is planned to use the medical device in connection with this intended purpose only. In participating hospitals, patients will be treated with this new treatment strategy of minimally invasive ultrafiltration treatment in support of diuretic drug therapy in the acute phase of volume overload. It is possible with the use of ultrafiltration therapy to control volume overload and reduce it on an individual basis, so that diuretics can be given sparingly and, as a consequence, diuretic resistance and a deterioration of renal function due to diuretic uptitration can be avoided.

Being tested
periph. minimal invasive ultrafiltration
Keywords
volume overload, heart failure, cardiac decompensation, ultrafiltration
Medical subject headings
Heart Failure, Edema

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • periph. minimal invasive ultrafiltrationDevice

    Also called ultrafiltration

    ultrafiltration via a peripheral single-needle

Study groups in NCT02769351
Study groupRoleWhat they receive
periph. minimal invasive ultrafiltrationPatients with volume overload receiving ultrafiltration
Receives: Device: periph. minimal invasive ultrafiltration

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rehospitalisation (Yes/no) Due to Exacerbation of Heart Failure/Volume Overload of Other Origin

    The number of rehospitalizations due to heart failure resp. volume overload has been measured as a clinical endpoint and analyzed based on the AP.

    Measured: 12 months

Secondary outcomes (4)
  1. Significant Deterioration of Kidney Function - Creatinine

    Significant deterioration of kidney function has been measured as a safety endpoint and analyzed based on the SP. The variables have been measured at recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months) and Outpatient visit II (12 months).

    Measured: Recruitment; Discharge from Index Hospitalization; Outpatient visit I (3-9 months); Outpatient visit II ( 12 months)

  2. Significant Deterioration of Kidney Function - Urea

    Significant deterioration of kidney function has been measured as a safety endpoint and analyzed based on the SP. The variables have been measured at recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months) and Outpatient visit II (12 months).

    Measured: Recruitment; Discharge from Index Hospitalization; Outpatient visit I (3-6 months); Outpatient visit II (12 months)

  3. Significant Deterioration of Kidney Function - eGFR (Estimated Glomerular Filtration Rate)

    Significant deterioration of kidney function has been measured as a safety endpoint and analyzed based on the SP. The variables have been measured at recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months) and Outpatient visit II (12 months).

    Measured: Recruitment, Discharge from index hospitalization, Outapteint visit I (3-6 months), Outpatient visit II (12 months)

  4. Significant Deterioration of Kidney Function - Cystatin

    Significant deterioration of kidney function has been measured as a safety endpoint and analyzed based on the SP. The variables have been measured at recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months) and Outpatient visit II (12 months).

    Measured: recruitment, discharge from the index hospitalization, Outpatient visit I (3-9 months), Outpatient visit II (12 months)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 May 2016 (estimated)
  2. Study start3 Dec 2015
  3. Primary completion4 Mar 2019
  4. Study completion4 Mar 2019

Why it stopped: It was decided to prematurely terminate the GENTLE-UF registry as a parallel study conducted with the same device has been prematurely terminated due to low recruitment.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case only
Time perspective
Prospective
Enrolment
104 participants (actual)
Target duration
12 Months
IDs, dates and publications
ClinicalTrials.gov ID
NCT02769351
Sponsor's protocol ID
UF-HF-01-INT
Other IDs
DRKS00009836
Acronym
GENTLE-UF
Status last verified
Apr 2021
First submitted
21 Mar 2016
Last updated
5 Aug 2021
Data monitoring committee
No
Individual data sharing
No: Overall results will be published. Individual participant data will not be made available.

Publications

  • Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL; American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013 Oct 15;62(16):e147-239. doi: 10.1016/j.jacc.2013.05.019. Epub 2013 Jun 5. No abstract available.

    PubMed 23747642
  • McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Kober L, Lip GY, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Ronnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A; Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology; Bax JJ, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, McDonagh T, Sechtem U, Bonet LA, Avraamides P, Ben Lamin HA, Brignole M, Coca A, Cowburn P, Dargie H, Elliott P, Flachskampf FA, Guida GF, Hardman S, Iung B, Merkely B, Mueller C, Nanas JN, Nielsen OW, Orn S, Parissis JT, Ponikowski P; ESC Committee for Practice Guidelines. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012 Aug;14(8):803-69. doi: 10.1093/eurjhf/hfs105. No abstract available.

    PubMed 22828712

Questions about this trial

What is this clinical trial studying?

An observational study of Acute Heart Failure and Cardiac Decompensation, run by Fresenius Medical Care Deutschland GmbH at 19 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 5 Aug 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in Germany, Sweden, Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 8 Jul 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rehospitalisation (Yes/no) Due to Exacerbation of Heart Failure/Volume Overload of Other Origin (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02769351, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Aug 2021.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in