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Heart Failure With Preserved Ejection FractionPhase 2/3SOGALDI-PEFNCT05676684

Dapagliflozin With or Without Spironolactone for HFpEF

A Phase 2/3 study testing Dapagliflozin and Spironolactone + Dapagliflozin in people with Heart Failure With Preserved Ejection Fraction, run by Universidade do Porto at 2 sites in Portugal.

Completed

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

Official record
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Trial summary

Heart failure (HF) is a condition in which the heart does not contract ("pump") or relax well, leading to insufficient perfusion of vital organs. Ankle swelling, fatigue, and breathlessness are some of the features of this syndrome. Read more about this study

Who is it for?
Ages 50 years and older
What is being tested?
Dapagliflozin and Spironolactone + Dapagliflozin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
108 participants
Where
2 sitesPortugal
Study dates
15 Sep 2022to 29 Nov 2024
Phase
Phase 2/3
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 50 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Provision of informed consent prior to any study specific procedures
  • HFpEF diagnosis* (irrespective of time since diagnosis)
  • Male or female patients, aged ≥50 years
  • NYHA Class II-IV
  • LVEF > 40%
  • NT-pro BNP ≥220 pg/mL or BNP ≥80 pg/mL if in sinus rhythm (SR)
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  • NT-pro BNP ≥660 pg/mL or BNP ≥240 pg/mL if in atrial fibrillation (AF)
  • Echocardiography with at least one of the following criteria:
  • LAVI ≥29 ml/m2 (≥34 ml/m2 if AF)
  • Lateral E/e' ≥9
  • LVMI ≥115 g/m2 If male or ≥95 g/m2 if female
  • LV wall thickness ≥12mm
  • eGFR ≥30 ml/min/1.73m2 (CKD-EPI formula)
  • Blood Potassium ≤5.5 mmol/L
  • Not treated with MRAs and/or SGLT2i within the previous two weeks before inclusion and have no history of diabetic ketoacidosis while in treatment with SGLT2 inhibitors
  • Stable/chronic ambulatory patients i.e., patients without need for hospitalization within the last 30 days due to heart failure decompensation episodes
  • If female, she must be a woman of non-childbearing potential. That is, she must be:
  • Surgically sterilized (e.g. underwent hysterectomy, bilateral salpingectomy or bilateral oophorectomy)
  • Clinically diagnosed infertile
  • In a post-menopausal state, defined as no menses for 12 months without an alternative medical cause.
  • A female patient of childbearing potential must have a negative serum pregnancy test at Visit 1 (Day 0) and must agree to use consistently and correctly (from 28 days prior to first study treatment administration until at least 7 days after last study treatment administration) one of the following highly effective methods of contraception:
  • Abstinence of heterosexual intercourse (when this is in line with preferred and usual lifestyle of the subject)
  • Progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable)
  • Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, transdermal)
  • Intrauterine device
  • Intrauterine hormone-releasing system
  • Bilateral tubal occlusion
  • Vasectomized partner, who has received medical assessment of the surgical success, or clinically diagnosed infertile partner

Who cannot join

  • Involvement in the planning and/or conduct of the study (applies to both Investigator staff and/or staff at the study site)
  • Participation in another clinical study with an investigational product during the last month
  • Unwilling to sign the informed consent form (if the patient wants to participate but cannot sign for any reason, then a third-person testimony may sign/complete informed consent form on patient's behalf)
  • Major surgical procedure, coronary, cerebral or peripheral vascular events or sepsis in the prior 90 days
  • Cancer (life-limiting or less than 2 years in remission)
  • Any previously confirmed autoimmune disease
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  • Type 1 Diabetes
  • Ability to walk is, in the investigator's opinion, clearly limited by joint disease or other locomotor problems or lung diseases rather than by cardiorespiratory fitness
  • Previously confirmed cardiac amyloidosis
  • Severe valvulopathy according to the echocardiogram report
  • Patients with a known hypersensitivity or intolerance to spironolactone or dapagliflozin or any of the excipients of the products.
  • Female patients currently pregnant (confirmed by a positive pregnancy test) or intent to become pregnant or breast feeding.

Trial locations and contacts

2 sites in 1 country.

Portugal2 sites
  • Unidade Local de Saúde Gaia/Espinho

    Porto, Gaia, 4434-502

  • Centro Hospitalar Universitário São João

    Porto, 4200-319

Other trials in Portugal

About this study

Official title: SOdium-Glucose Cotransporter 2 Inhibitor With and Without an ALDosterone AntagonIst for Heart Failure With Preserved Ejection Fraction: a Two-centre Randomised Crossover Trial

Heart failure (HF) is a condition in which the heart does not contract ("pump") or relax well, leading to insufficient perfusion of vital organs. Ankle swelling, fatigue, and breathlessness are some of the features of this syndrome. There are different causes for HF (eg., infarct and hypertension) and two distinct types: HFrEF - HF with reduced ejection fraction - where the heart does not "pump" properly, and HFpEF - HF with preserved ejection fraction - the heart "pumps" but does not relax well. Treatment for HFrEF is better established than for HFpEF. In HFpEF, only mineralocorticoid receptors antagonists (MRAs) have been shown to reduce hospitalizations, circulating markers of cardiac dysfunction and fibrosis, and blood pressure. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a therapeutic class that reduces morbidity and mortality in patients with high cardiovascular risk and diabetes and in patients with HFrEF with and without diabetes. Trials are underway to test whether SGLT2i may also be useful for the treatment of HFpEF. This work aims to compare the effects of SGLT2i alone and in combination in an MRA in patients with HFpEF.

Being tested
Dapagliflozin, Spironolactone + Dapagliflozin

What participants receive

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

  • DapagliflozinDrug

    Also called Forxiga(R)

    A: Dapagliflozin 10 mg once daily

  • Spironolactone + DapagliflozinDrug

    Also called Forxiga(R) + Aldactone(R)

    C: Dapagliflozin 10 mg once daily plus Spironolactone 25mg/every other day or 25mg/day (can be adjusted according to potassium and renal function)

Study groups in NCT05676684
Study groupRoleWhat they receive
[Dapagliflozin] - [Dapagliflozin + Spironolactone]ExperimentalDrug will be administered according to sequence: Dapagliflozin [week 1-12] - Dapagliflozin + Spironolactone [week 13-25]
Receives: Drug: Dapagliflozin; Drug: Spironolactone + Dapagliflozin
[Dapagliflozin + Spironolactone] - [Dapagliflozin]ExperimentalDrug will be administered according to sequence: Dapagliflozin + Spironolactone [week 1-12] - Dapagliflozin [week 13-25]
Receives: Drug: Dapagliflozin; Drug: Spironolactone + Dapagliflozin

What is being measured

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

  1. Blood levels of NT-pro BNP (Log transformed)

    Comparison of NT-pro BNP levels between groups

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

Secondary outcomes (13)
  1. Proportion of patients reaching a 20% or greater reduction in NT-proBNP levels

    Measured in blood samples

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  2. Circulating levels of PICP, PIIINP and CITP

    Measured in blood samples the circulating levels of procollagen type I carboxy-terminal propeptide (PICP), N-terminal propeptide of procollagen type III (PIIINP), C-terminal telopeptide of collagen type I (CITP)

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  3. Indexed Left Atrial Volume (LAVi)

    Transthoracic echocardiogram

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  4. Left Ventricular Ejection Fraction (LVEF)

    Transthoracic echocardiogram

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  5. Lateral E/e

    Transthoracic echocardiogram

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  6. Indexed Left Ventricular Mass (LVMi)

    Transthoracic echocardiogram

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  7. Pulmonary Artery Systolic Pressure (PASP)

    Transthoracic echocardiogram

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  8. Systolic and Diastolic Blood Pressure (SBP/DBP)

    Measure in the clinical appointment after 5min of seated rest. Mean of 3 automatic oscillometric measurements

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  9. Estimated glomerular filtration rate (eGFR)

    Calculated from the serum creatinine using the 2021 CKD-EPI creatinine-based formula

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  10. Microalbuminuria (log-transformed)

    Spot urine

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  11. Urinary sodium/natriuresis

    Spot urine

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  12. Serum potassium (K+)

    Concentration of potassium in the blood

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

  13. Health-related quality of life (HR-QoL)

    HR-QoL assessed by the Kansas City Cardiomyopathy Questionnaire a 23-item instrument. All items are measured on a Likert scale with 5-7 response options. KCCQ scores are scaled from 0 to 100 and summarized in 25-point ranges, where scores represent health status as follows: 0 to 24: very poor to poor; 25 to 49: poor to fair; 50 to 74: fair to good; and 75 to 100: good to excellent

    Measured: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]

Timeline

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

  1. First posted9 Jan 2023
  2. Study start15 Sep 2022
  3. Primary completion29 Nov 2024
  4. Study completion29 Nov 2024

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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
Prospective, randomised, open-label, two-treatment, two-period, cross-over trial
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
108 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05676684
Sponsor's protocol ID
SOGALDI-PEF
Acronym
SOGALDI-PEF
Status last verified
Mar 2025
First submitted
6 Dec 2022
Last updated
17 Aug 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Ferreira JP, Marques P, Neves JS, Leite AR, Teixeira C, Saraiva F, Sharma A, Zannad F, Pimenta J, Fontes-Carvalho R, Leite-Moreira A, Vasques-Novoa F; SOGALDI-PEF Investigators. Renin, Aldosterone, and Treatment Response to Dapagliflozin, Spironolactone, and Their Combination: An Analysis From SOGALDI-PEF. JACC Heart Fail. 2026 May 22:103111. doi: 10.1016/j.jchf.2026.103111. Online ahead of print.

    PubMed 42201301
  • Ferreira JP, Vasques-Novoa F, Saraiva F, Oliveira AC, Almeida J, Batista AB, Barbosa A, Ferreira AF, Costa C, Diaz SO, Santos-Ferreira D, Frioes F, Goncalves C, Guimaraes JT, Leite M, Marques P, Mascarenhas J, Matos MI, Pereira C, Rodrigues P, Sharma A, Silva G, Pereira-Sousa I, Sousa C, Zannad F, Pimenta J, Fontes-Carvalho R, Leite-Moreira A. Sodium-Glucose Cotransporter 2 Inhibitor With and Without an Aldosterone Antagonist for Heart Failure With Preserved Ejection Fraction: The SOGALDI-PEF Trial. J Am Coll Cardiol. 2025 Aug 5;86(5):320-333. doi: 10.1016/j.jacc.2025.05.033.

    PubMed 40738559

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Dapagliflozin and Spironolactone + Dapagliflozin in people with Heart Failure With Preserved Ejection Fraction, run by Universidade do Porto at 2 sites in Portugal.

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 28 inclusion and 12 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 17 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Portugal. 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.

What does this combined 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.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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?

Blood levels of NT-pro BNP (Log transformed) (time frame: Visit 1 Day 0 / Visit 2 Day 84 [Day 77 to Day 91] / Visit 3 Day 175 [Day 168 to Day 182]). 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 NCT05676684, 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 17 Aug 2025.

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