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Cardiogenic ShockPhase 3EMPASHOCKNCT05879276

Effect at 3 Months of Early Empagliflozin Initiation in Cardiogenic Shock Patients on Mortality, Rehospitalization, Left Ventricular Ejection Fraction and Renal Function.

A Phase 3 study testing Empagliflozin 10 MG in people with Cardiogenic Shock, run by Central Hospital, Nancy, France at 8 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Long term prognosis of cardiogenic shock is related to the resolution of haemodynamic failure, associated visceral failure and the recovery of an adequate myocardial function. In the immediate aftermath of cardiogenic shock, after catecholamines weaning, there are no recommendations on cardiovascular treatments that… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cardiogenic Shock
What is being tested?
Empagliflozin 10 MG
Could I receive a placebo?
No, everyone receives an active treatment
How many people
164 participants
Where
8 sitesFrance
Study dates
16 Dec 2024to 16 Mar 2027
Phase
Phase 3
Are there results?
Not yet: the study is under way

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

Who may be able to join

  • Adult patients hospitalized in critical cardiac unit care or Intensive care unit for a cardiogenic shock
  • "Who must have been or is on catecholamines for at least 12 hours for the treatment of cardiogenic shock.
  • Patients who are able to take oral tablets

Who cannot join

  • GFR< 20 ml/min/1.73m2.
  • Chronic dialysis.
  • Patient on SGLT2 inhibitors prior to admission to ICU or CCU.
  • Known allergy to SGLT2 inhibitors or to any of its excipients (in particular, patients with hereditary disorders of galactose intolerance, total lactase deficiency or glucose or galactose malabsorption syndrome)
  • Patients on lithium.
  • Patient in shock for another cause or moribund (SAPS2> 90).
Show all 13Show fewer
  • Specific cardiogenic shock context:
  • cardiac transplant patient or on transplant list.
  • peripartum, adrenergic, valvular, non ischemic, post embolic heart disease.
  • related to cardiotropic drug intoxication.
  • Secondary to a cardiac arrest for which the patient remains comatose prior to inclusion.
  • Women of childbearing age without effective contraception.
  • Person referred to in Articles 10, 31, 32, 33 and 34 of EU Regulation 536/2014 (Pregnant woman, parturient or breastfeeding mother, Minor (not emancipated), Adult person subject to a legal protection measure (guardianship, curatorship, safeguard of justice))

Trial locations and contacts

8 sites in 1 country. Contact the study team or a site near you to ask about taking part.

8 sites in 1 country

France8 sites, 8 recruiting
  • CHR Metz - Thionville

    Ars-Laquenexy, 57000

    Guillaume LOUIS, MD, +33 3 87 55 31 31, guillaume.louis@chr-metz-thionville.fr

    Guillaume LOUIS, MD

    Recruiting
  • CHU de Besançon

    Besançon, 25000

    Hadrien WINISZEWSKI, Md PhD, +33 3 81 66 81 66., hwiniszewski@chu-besancon.fr

    Hadrien WINISZEWSKI, MD PhD

    Recruiting
  • CHU de Dijon Bourgogne

    Dijon, 21000

    Jean Pierre QUENOT, MD

    Jean Pierre QUENOT, MD PhD

    Not yet recruiting
  • CHU Lille

    Lille, 59000

    LEMESLE Gilles, MD PhD, +33 3 20 44 59 62, gilles.lemesle@chru-lille.fr

    Gilles LEMESLE, MD pHD

    Not yet recruiting
  • CHU Reims

    Reims, 51000

    Bruno MOURVILLIER, MD PhD

    Bruno MOURVILLIER, MD PhD

    Not yet recruiting
  • Hôpitaux Universitaires de Strasbourg

    Strasbourg, 67000

    Hamid MERDJI, MD PhD, +33 3 88 11 67 68, hamid.merdji@chru-strasbourg.fr

    Hamid MERDJI, MD PhD

    Recruiting
  • CHRU de NANCY - réanimation médicale

    Vandœuvre-lès-Nancy, 54500

    Antoine KIMMOUN, MD PhD, +33 3 83 85 85 85, a.kimmoun@chru-nancy.fr

    Antoine KIMMOUN, MD PhD

    Recruiting
  • Chru Nancy - Usic

    Vandœuvre-lès-Nancy, 54500

    Popovic BATRIC, MD PhD, +33383858585, b.popovic@chru-nancy.fr

    Batric POPOVIC, MD pHD

    Recruiting

Other trials in France

About this study

Official title: Effect at 3 Months of Early Empagliflozin Initiation in Cardiogenic Shock Patients on Mortality, Rehospitalization, Left Ventricular Ejection Fraction and Renal Function. A Randomized Multicentric Open Trial

Long term prognosis of cardiogenic shock is related to the resolution of haemodynamic failure, associated visceral failure and the recovery of an adequate myocardial function. In the immediate aftermath of cardiogenic shock, after catecholamines weaning, there are no recommendations on cardiovascular treatments that would improve this long term prognosis. Indeed, the standard cardiovascular treatments such as inhibitors of the renin-angiotensin and aldosterone system and beta-blockers have hypotensive and negative inotropic effects and may worsen the renal function. In practice, given their side effects, they are not prescribed in the immediate aftermath of cardiogenic shock.

Sodium-glucose co-transporter 2 (iSGLT2) inhibitors are now an integral part of the drug management of chronic heart failure and the EMPULSE-HF trial has just demonstrated a benefit in acute heart failure (PMID: 35228754). Several pivotal clinical trials have demonstrated a significant effect of iSGLT2 on the survival and the risk of re hospitalisation for heart failure (PMID: 32865377, 31535829, 33200892). Our hypothesis is that, in patients in cardiogenic shock, early treatment with Empaglifozin in addition to the standard management could reduce mortality and morbidity (death, transplantation/LVAD and rehospitalisation for heart failure) and improve myocardial function at 12 weeks, compared with standard management alone.

Being tested
Empagliflozin 10 MG
Keywords
Heart failure, Acute heart failure, Cardiogenic shock, SGLT2 inhibitor, Mortality
Medical subject headings
Shock, Cardiogenic, Heart Failure

What participants receive

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

  • Empagliflozin 10 MGDrug

    Patients in cardiogenic shock receiving empagliflozin in addition to standard management at a dose of 10 mg per day per os (or through nasogastric tube in intubated patients) for a duration of 12 weeks.

Study groups in NCT05879276
Study groupRoleWhat they receive
Empaglifozin in addition to standard managementExperimentalPatients in cardiogenic shock receiving empagliflozin in addition to standard management at a dose of 10 mg per day per os (or through nasogastric tube in intubated patients) for a duration of 12 weeks
Receives: Drug: Empagliflozin 10 MG
Standard managementNo interventionPatients in cardiogenic shock receiving a standard management. SGLT2 inhibitor, which are now standard of care in chronic heart failure, in the strict respect of their indications, could be prescribed in the standard management group after hospitalization discharge.

What is being measured

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

  1. Time to all-cause death

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on composite endpoint components:

    1. All-cause mortality or heart transplantation or ventricular assist,
    2. Rehospitalization for heart failure,
    3. Left ventricular ejection fraction.

    Hierarchical composite endpoint, assessed at 12 weeks from randomization (win-ratio method):

    • Rank 1: Time to all-cause death or cardiac transplantation or mechanical ventricular assist,
    • Rank 2: Time to rehospitalization for heart failure,
    • Rank 3: Left ventricular ejection fraction assessed during a research cardiac ultrasound.

    Measured: 12-week after randomisation

  2. Time to cardiac transplantation

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on composite endpoint components:

    1. All-cause mortality or heart transplantation or ventricular assist,
    2. Rehospitalization for heart failure,
    3. Left ventricular ejection fraction.

    Hierarchical composite endpoint, assessed at 12 weeks from randomization (win-ratio method):

    • Rank 1: Time to all-cause death or cardiac transplantation or mechanical ventricular assist,
    • Rank 2: Time to rehospitalization for heart failure,
    • Rank 3: Left ventricular ejection fraction assessed during a research cardiac ultrasound.

    Measured: 12-week after randomisation

  3. Time to mechanical ventricular assist

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on composite endpoint components:

    1. All-cause mortality or heart transplantation or ventricular assist,
    2. Rehospitalization for heart failure,
    3. Left ventricular ejection fraction.

    Hierarchical composite endpoint, assessed at 12 weeks from randomization (win-ratio method):

    • Rank 1: Time to all-cause death or cardiac transplantation or mechanical ventricular assist,
    • Rank 2: Time to rehospitalization for heart failure,
    • Rank 3: Left ventricular ejection fraction assessed during a research cardiac ultrasound.

    Measured: 12-week after randomisation

  4. Time to rehospitalization for heart failure.

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on composite endpoint components:

    1. All-cause mortality or heart transplantation or ventricular assist,
    2. Rehospitalization for heart failure,
    3. Left ventricular ejection fraction.

    Hierarchical composite endpoint, assessed at 12 weeks from randomization (win-ratio method):

    • Rank 1: Time to all-cause death or cardiac transplantation or mechanical ventricular assist,
    • Rank 2: Time to rehospitalization for heart failure,
    • Rank 3: Left ventricular ejection fraction assessed during a research cardiac ultrasound.

    Measured: 12-week after randomisation

  5. Left ventricular ejection fraction assessed by cardiac ultrasound.

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on composite endpoint components:

    1. All-cause mortality or heart transplantation or ventricular assist,
    2. Rehospitalization for heart failure,
    3. Left ventricular ejection fraction.

    Hierarchical composite endpoint, assessed at 12 weeks from randomization (win-ratio method):

    • Rank 1: Time to all-cause death or cardiac transplantation or mechanical ventricular assist,
    • Rank 2: Time to rehospitalization for heart failure,
    • Rank 3: Left ventricular ejection fraction assessed during a research cardiac ultrasound.

    Measured: 12-week after randomisation

Secondary outcomes (16)
  1. Death

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on all-cause mortality at 12 weeks from randomization

    Measured: 12-week after randomisation

  2. Heart transplantation or long-term ventricular assistance

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on heart transplantation or long-term ventricular assistance, at 12 weeks from randomization

    Measured: 12-week after randomisation

  3. Rehospitalization for heart failure

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on rehospitalization for heart failure, at 12 weeks from randomization

    Measured: from hospital discharge to 12-week after randomisation

  4. Left ventricular ejection fraction assessed by cardiac ultrasound.

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on left ventricular ejection fraction, at 12 weeks from randomization.

    Measured: 12-week after randomisation

  5. E' wave assessed by cardiac ultrasound

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the left ventricular diastolic function and filling pressures, at 12 weeks from randomization.

    Measured: 12-week after randomisation

  6. E/e' ratio assessed by cardiac ultrasound

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the left ventricular diastolic function and filling pressures, at 12 weeks from randomization.

    Measured: 12-week after randomisation

  7. TAPSE assessed by cardiac ultrasound

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the right ventricular function, at 12 weeks from randomization

    Measured: 12-week after randomisation

  8. S wave at the annular tricuspid level assessed by cardiac ultrasound

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the right ventricular function, at 12 weeks from randomization

    Measured: 12-week after randomisation

  9. Renal replacement therapy

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the renal function, at 12 weeks from randomization

    Measured: Randomisation and 12-week after randomisation

  10. Renal function

    The number of patients requiring renal replacement therapy between randomization and 12 weeks, and change in renal function assessed at baseline and 12 weeks: glomerular filtration rate calculated by the CKD-EPI method

    Measured: Randomisation and 12-week after randomisation

  11. Bilirubin

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the hepatic function, at 12 weeks from randomization

    Measured: Randomisation and 12-week after randomisation

  12. Prothrombin Ratio (PT)

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the hepatic function, at 12 weeks from randomization

    Measured: Randomisation and 12-week after randomisation

  13. SGOT

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the hepatic function, at 12 weeks from randomization

    Measured: Randomisation and 12-week after randomisation

  14. SGPT

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the hepatic function, at 12 weeks from randomization

    Measured: Randomisation and 12-week after randomisation

  15. NT-Pro-BNP

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the evolution of the hydro-sodic overload, at 12 weeks from randomization. The measure of NT-Pro-BNP will be measured at 12 weeks and delta from randomisation will be calculated

    Measured: Randomisation and 12-week after randomisation

  16. Weight

    To compare the effect of early introduction of empagliflozin in addition to standard management versus standard management alone on the evolution of the hydro-sodic overload, at 12 weeks from randomization. The weight will be measured at 12 weeks and delta from randomisation will be calculated

    Measured: Randomisation and 12-week after randomisation

Timeline

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

  1. First posted30 May 2023
  2. Study start16 Dec 2024
  3. Primary completion16 Mar 2027 (estimated)
  4. Study completion16 Mar 2027 (estimated)

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Multicentre, interregional, randomised, controlled, open-label clinical trial evaluating the effect of early initiation of a SGLT2 inhibitor i.e Empaglifozin, in cardiogenic shock.
Masking
None (open label)
Enrolment
164 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05879276
Sponsor's protocol ID
2023PI223 - 2023-503602-37-00
Acronym
EMPASHOCK
Status last verified
Jun 2025
First submitted
12 Apr 2023
Last updated
27 Jun 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Empagliflozin 10 MG in people with Cardiogenic Shock, run by Central Hospital, Nancy, France at 8 sites in France.

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 3 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: looking for participants now, as of the sponsor's last update on 27 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in France. 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 phase mean?

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?

This study is still under way. Results are not available in the source record yet.

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

Contact Antoine KIMMOUN, MD PhD (3 83 15 40 79 ext. +33, a.kimmoun@chru-nancy.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time to all-cause death (time frame: 12-week after randomisation). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 27 Jun 2025.

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