AzTrials
AzTrials

Chronic Heart FailurePhase 2ELSINCT03128528

Analysing the Effect of Empagliflozin on Reduction of Tissue Sodium Content in Patients With Chronic Heart Failure

A Phase 2 study testing Empagliflozin 10mg in people with Chronic Heart Failure, run by University of Erlangen-Nürnberg Medical School at 1 site in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The hypothesis is that the SGLT-2 inhibitor empagliflozin reduces tissue sodium content in patients with chronic heart failure, and if the hypothesis is proven, that this mechanism contributes to the beneficial effects found in EMPA-REG Outcome trial potentially via exerting beneficial effects on the vascular… Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Chronic Heart Failure
What is being tested?
Empagliflozin 10mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
84 participants
Where
1 siteGermany
Study dates
1 Jul 2017to 30 Apr 2020
Phase
Phase 2
Are there results?
None posted in the registry

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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age of 18 - 85 years
  • Male and Female patients (females of child bearing potential must be using adequate contraceptive precautions)
  • CHF (symptoms and/or sign of CHF, ejection fraction < 40% (HfrEF) 14 or symptoms and/or signs of CHF, ejection fraction 40-49 % and NT-pro BNP > 125 pg/ml, and at least one structural abnormality of left atrium or ventricle (HFmEF) 14 in stable conditions.
  • Females of childbearing potential or within two years of the menopause must have a negative urine pregnancy test at screening visit.
  • Informed consent has to be given in written form.

Who cannot join

  • Any other form of diabetes mellitus than type 2 diabetes mellitus
  • Use of insulin or any SGLT-2 inhibitor within the past 10 weeks prior to the screening visit (visit 1).
  • Patients with more than two blood glucose lowering medications
  • Uncontrolled diabetes (fasting plasma glucose ≥ 240 mg/dl, HbA1c ≥ 10%)
  • Any history of stroke, transient ischemic attack, instable angina pectoris, or myocardial infarction within the last 6 months prior to study inclusion
  • Estimated glomerular filtration rate (eGFR) < 30 ml/min/1.73m² (following the inclusion criteria of EMPA-REG OUTCOME study 1-3)
Show all 13Show fewer
  • Chronic heart failure NYHA stage IV
  • Use of loop diuretics above furosemide > 80 mg/day, or torasemide >40 mg/day, or piretanide > 6 mg/day
  • Implanted pacemakers or defibrillators
  • Any other relevant clinical contraindication of MRI examination
  • Uncontrolled arterial hypertension (i.e. ≥ 180/110 mmHg)
  • Severe disorders of the gastrointestinal tract or other diseases which interfere with the pharmacodynamics and pharmacokinetics of study drugs
  • Significant laboratory abnormalities such as Serum Glutamate-Oxaloacetate-Transaminase (SGOT) or Serum Glutamate-Pyruvate-Transaminase (SGPT) levels more than 3 x above the upper limit of normal range

Trial locations and contacts

1 site in 1 country.

Germany1 site
  • Clinical Research Center, Department of Nephrology and Hypertension, University of Erlangen-Nuremberg

    Erlangen, 91054

Other trials in Germany

About this study

Official title: Randomized, Double-blind, Placebo Controlled, Parallel-group, Prospective Clinical Study to Analyse the Effect of Empagliflozin on Reduction of Tissue Sodium Content in Patients With Chronic Heart Failure

The hypothesis is that the SGLT-2 inhibitor empagliflozin reduces tissue sodium content in patients with chronic heart failure, and if the hypothesis is proven, that this mechanism contributes to the beneficial effects found in EMPA-REG Outcome trial potentially via exerting beneficial effects on the vascular structure and function of the micro- and macrocirculation.

Read the detailed description

SGLT-2 inhibitors such as empagliflozin inhibit the SGLT-2 transport in the proximal tubular cells of the kidney, thereby causing glucosuria to approximately 100 g per day (and sometimes even more). The SGLT-2 inhibition does not only cause glucosuria but also natriuresis, since with each molecule of glucose one molecule of sodium is inhibited to be reabsorbed. Indeed, during the first week SGLT-2 inhibition causes clinically detectable natriuresis but its effect in the long run is not yet illustrated. Of course, a new sodium balance will be achieved after a certain time (otherwise the human body would be completely salt depleted), but total sodium content could be different. With new innovative magnetic resonance imaging (MRI) technology we are able to assess tissue sodium content in the skin and muscle, and observed that sodium content is significantly increased with aging, severe hypertension or hyperaldosteronism. Furthermore, skin sodium content assessed by MRI was closely related to left ventricular mass (r=0.559, p<0.0001, N=89) independently of age, gender, body mass index, and 24 h ambulatory blood pressure (β=0.343, p=0.001, N=89) 11. Using this technology, our first yet unpublished data (clinicaltrials.gov: NCT02383238) indicate that SGLT-2 inhibition decreases sodium content in the skin in patients with diabetes. Finally, we observed previously that in patients with acute chronic heart failure skin sodium content decreased from 43.5 mmol/l to 32.2 mmol/l after diuretic therapy.

Thus, the present study aims at analyzing changes in total and tissue sodium content after SGLT-2 inhibition with empagliflozin. In parallel, sodium intake and excretion and central systolic and pulse pressure as well as other vascular parameters will be assessed. In face of the upcoming studies with empagliflozin conducted in patients with reduced and preserved ejection fraction (two large-scale, prospective, doubleblind, placebo controlled studies planned by Boehringer Ingelheim as the sponsor), we thought that we focus on patients with chronic heart failure irrespective diabetic status. The hypothesis is that the SGLT-2 inhibitor empagliflozin reduces tissue sodium content in patients with chronic heart failure, and if the hypothesis is proven, that this mechanism contributes to the beneficial effects found in EMPA-REG Outcome trial potentially via exerting beneficial effects on the vascular structure and function of the micro- and macrocirculation.

Being tested
Empagliflozin 10mg, Placebo Oral Tablet
Keywords
SGLT-2 inhibitor, Chronic heart failure, tissue sodium,

What participants receive

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

  • Empagliflozin 10mgDrug

    Also called EMPA

    Each patient, after the run-in/wash-out phase, will be randomly assigned in a doubleblind fashion to one of the two treatment sequences according to a randomisation list.

    and provided by the sponsor.

  • Placebo Oral TabletDrug

    Also called PLACEBO

    Each patient, after the run-in/wash-out phase, will be randomly assigned in a doubleblind fashion to one of the two treatment sequences according to a randomisation list.

    and provided by the sponsor.

Study groups in NCT03128528
Study groupRoleWhat they receive
Placebo Oral TabletPlacebo comparatorPatients will be randomized to empagliflozin 10 mg orally once daily or one placebo tablet orally once daily.
Receives: Drug: Placebo Oral Tablet
EmpagliflozinActive comparatorPatients will be randomized to empagliflozin 10 mg orally once daily or one placebo tablet orally once daily.
Receives: Drug: Empagliflozin 10mg

What is being measured

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

  1. Skin sodium content

    Skin sodium content (23Na-MRI) assessed at the lower leg

    Measured: 14 weeks

Secondary outcomes (13)
  1. Muscle sodium content

    Sodium content of muscles

    Measured: 14 weeks

  2. Water content of skin and muscle

    Water content (1H) of skin and muscle

    Measured: 14 weeks

  3. Sodium excretion

    Sodium excretion as assessed by sodium creatinine ratio in spot urine

    Measured: 14 weeks

  4. 24-hour urine sodium excretion

    24-hour urine sodium excretion

    Measured: 14 weeks

  5. Vascular stiffness Parameter (central systolic pressure)

    Vascular stiffness Parameter under resting conditions and ambulatory conditions and their association to change in tissue sodium content

    Measured: 14 weeks

  6. Flow mediated vasodilation

    Flow mediated vasodilation (FMD) as measured by semiautomated ultrasound system

    Measured: 14 weeks

  7. N-terminal prohormone of brain natriuretic peptide

    N-terminal prohormone of brain natriuretic peptide (NT-pro-BNP) to assess their relation to change in tissue sodium content

    Measured: 14 weeks

  8. Body weight

    Measurement of body weight in kg

    Measured: 14 weeks

  9. HbA1c

    Diabetic control (e.g. fasting glucose, glycosylated hemoglobin [HbA1c])

    Measured: 14 weeks

  10. ABPM

    24-hour ambulatory blood pressure (ABP)

    Measured: 14 weeks

  11. Visual analogue scale for dyspnea

    Visual analogue scale for dyspnea to assess their relation to change in tissue sodium Content.

    Measured: 14 weeks

  12. Body constitution

    Body constitution (fluid status based on three compartment model lean body mass, adipose tissue mass and overhydration)

    Measured: 14 weeks

  13. Vascular stiffness Parameter (Pulse pressure)

    Vascular stiffness Parameter under resting conditions and ambulatory conditions and their association to change in tissue sodium content

    Measured: 14 weeks

Timeline

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

  1. First posted25 Apr 2017
  2. Study start1 Jul 2017
  3. Primary completion31 Jan 2020
  4. Study completion30 Apr 2020

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Phase II, randomized (2:1), prospective, double-blind, placebo controlled, parallel-group, single center study.
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
84 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03128528
Sponsor's protocol ID
CRC2017ELSI
Acronym
ELSI
Status last verified
Sep 2020
First submitted
3 Apr 2017
Last updated
28 Sep 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Striepe K, Jumar A, Ott C, Karg MV, Schneider MP, Kannenkeril D, Schmieder RE. Effects of the Selective Sodium-Glucose Cotransporter 2 Inhibitor Empagliflozin on Vascular Function and Central Hemodynamics in Patients With Type 2 Diabetes Mellitus. Circulation. 2017 Sep 19;136(12):1167-1169. doi: 10.1161/CIRCULATIONAHA.117.029529. No abstract available.

    PubMed 28923906
  • Bytyqi V, Kannenkeril D, Kolwelter J, Linz P, Bosch A, Striepe K, Karg MV, Nagel AM, Uder M, Schiffer M, Achenbach S, Schmieder RE. Short- and mid-term effects of empagliflozin on sodium balance and fluid regulation in chronic heart failure. Eur J Heart Fail. 2025 Dec;27(12):3134-3141. doi: 10.1002/ejhf.70078. Epub 2025 Nov 4.

    PubMed 41186108
  • Kolwelter J, Kannenkeril D, Linz P, Jung S, Nagel AM, Bosch A, Ott C, Bramlage P, Noh L, Schiffer M, Uder M, Achenbach S, Schmieder RE. The SGLT2 inhibitor empagliflozin reduces tissue sodium content in patients with chronic heart failure: results from a placebo-controlled randomised trial. Clin Res Cardiol. 2023 Jan;112(1):134-144. doi: 10.1007/s00392-022-02119-7. Epub 2022 Oct 26.

    PubMed 36289063
  • Pietschner R, Kolwelter J, Bosch A, Striepe K, Jung S, Kannenkeril D, Ott C, Schiffer M, Achenbach S, Schmieder RE. Effect of empagliflozin on ketone bodies in patients with stable chronic heart failure. Cardiovasc Diabetol. 2021 Nov 9;20(1):219. doi: 10.1186/s12933-021-01410-7.

    PubMed 34753480

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Empagliflozin 10mg in people with Chronic Heart Failure, run by University of Erlangen-Nürnberg Medical School at 1 site in Germany.

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 5 inclusion and 13 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: finished, as of the sponsor's last update on 28 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Skin sodium content (time frame: 14 weeks). 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 NCT03128528, which also lists 4 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 28 Sep 2020.

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