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HyponatremiaPhase 3DASSOHNCT06020495

Systematic Use of DDAVP to Prevent Serum Sodium Overcorrection in Severe Hyponatremia

A Phase 3 study testing DDAVP and Standard hyponatremia treatment in people with Hyponatremia, run by Assistance Publique - Hôpitaux de Paris at 15 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

ICU patients with severe hyponatremia and a high risk of rapid SNa overcorrection. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hyponatremia
What is being tested?
DDAVP and Standard hyponatremia treatment
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
260 participants
Where
15 sitesFrance
Study dates
17 Dec 2024to Jan 2028
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

  • Adults ( ≥18 years)
  • Current admission in ICU
  • Severe hyponatremia defined by SNa <120 mmol/L in the presence of neurological symptoms (seizures, confusion defined as Glasgow score <= 14, or signs of brain herniation) or by SNa <115 mmol/L
  • Normal or decreased extracellular fluid volume

Who cannot join

  • Obvious increase of extracellular fluid volume (cirrhosis with ascites, congestive heart failure, nephrotic syndrome);
  • Hyponatremia caused by hyperglycaemia (> 30 mmol/L) or hypertriglyceridemia (10 g/L) or hyperproteinaemia (120 g/L)
  • Severe acute kidney injury (KDIGO 3)
  • Severe chronic kidney disease (eGFR <20 ml/min)
  • Coronary patients well stabilized with trinitrine-based medicines
  • Recent neurosurgery or traumatic brain injury
Show all 22Show fewer
  • Previous DDAVP or hypertonic fluid administration for the current episode of severe hyponatremia
  • SNa increased by 5 mmol or more between admission at hospital and randomisation (H0)
  • Known contraindication to DDAVP
  • Allergy
  • Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
  • History of unstable angina and/or known or suspected heart failure.
  • Willebrand disease type IIB
  • Severe previous neurologic disability (Glasgow Outcome Scale: GOS < 3)
  • Diabetes insipidus receiving DDAVP treatment
  • Moribund state (patient likely to die within 24h)
  • Need for invasive mechanic ventilation
  • Enrolment to another interventional study (clinical trial on medicinal product, medical device and interventional research involving human participants not concerning health product)
  • Pregnancy or breastfeeding
  • Subject deprived of freedom, subject under a legal protective measure
  • No affiliation to any health insurance system
  • Refusal to participate to the study (patient or legal representative or family member or close relative if present)

Trial locations and contacts

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

15 sites in 1 country

France15 sites, 15 recruiting
  • Médecine Intensive et Réanimation - Centre Hospitalier Universitaire Amiens-Picardie

    Amiens, 80054

    Julien MAIZEL, maizel.julien@chu-amiens.fr

    Julien MAIZEL

    Recruiting
  • Néphrologie, dialyse et transplantation - Service de médecine intensive Réanimation, CHU Amiens-Picardie

    Amiens, 80054

    Dimitri TITECA, titeca.dimitri@chu-amiens.fr

    Dimitri TITECA

    Not yet recruiting
  • Médecine Intensive et Réanimation - Hôpital Avicenne

    Bobigny, 93000

    Nicolas BONNET, nicolas.bonnet@aphp.fr

    Nicolas BONNET

    Recruiting
  • Réanimation Polyvalente - Hôpital Jean Verdier

    Bondy

    Nathan EBSTEIN, MD, nathan.ebstein@aphp.fr

    Nathan EBSTEIN, MD

    Recruiting
  • Médecine Intensive et Réanimation - Hôpital Louis Mourier

    Colombes, 92700

    Fabrice UHEL, fabrice.uhel@aphp.fr

    Fabrice UHEL

    Recruiting
  • Réanimation Polyvalente et Surveillance continue - Centre Hospitalier Sud Francilien

    Corbeil-Essonnes, 91100

    Guillaume CHEVREL, guillaume.chevrel@chsf.fr

    Guillaume CHEVREL

    Recruiting
  • Médecine Intensive et Réanimation - Hôpital Henri Mondor

    Créteil, 94000

    Romain ARRESTIER, romain.arrestier@aphp.fr

    Romain ARRESTIER

    Recruiting
  • Service de néphrologie - Soins intensifs - Dialyse - Transplantation, CHU Dijon

    Dijon, 21000

    Pierre-Henri BONNOT, pierrehenri.bonnot@chu-dijon.fr

    Pierre-Henri BONNOT

    Not yet recruiting
  • Médecine Intensive et Réanimation - Hôpital François Mitterand

    Dijon, 21079

    Jean-Pierre QUENOT, jean-pierre.quenot@chu-dijon.fr

    Jean-Pierre QUENOT

    Recruiting
  • Réanimation Polyvalente - Centre Hospitalier Départemental Vendée

    La Roche-sur-Yon, 85000

    Laurent MARTIN LEFEVRE, 02 51 44 60 88, laurent.martin-lefevre@chd-vendee.fr

    Laurent MARTIN LEFEVRE

    Recruiting
  • Réanimation Polyvalente, CHR Metz Thionville - Hôpital de Mercy

    Metz, 57085

    Guillaume LOUIS, guillaume.louis@chr-metz-thionville.fr

    Guillaume LOUIS

    Recruiting
  • Réanimation Médicale - Hôpital de Paris Saclay

    Orsay, 91400

    Matthieu LE MEUR, 01 64 54 30 30, m.lemeur@gh-nord-essonne.fr

    Matthieu LE MEUR

    Recruiting
  • Médecine Intensive et Réanimation - Hôpital de la Pitié Salpêtrière

    Paris, 75013

    Julien MAYAUX, julien.mayaux@aphp.fr

    Julien MAYAUX

    Recruiting
  • Médecine Intensive Réanimation - Hôpital Delafontaine

    Saint-Denis, 93200

    Nolan HASSOLD-RUGOLINO, nolan.hassold@ch-stdenis.fr

    Nolan HASSOLD-RUGOLINO

    Recruiting
  • Réanimation Polyvalente - Hôpital Foch

    Suresnes, 92150

    Benjamin ZUBER, b.zuber@hopital-foch.com

    Benjamin ZUBER

    Recruiting

Other trials in France

About this study

Official title: Systematic Use of DDAVP to Prevent Serum Sodium Overcorrection in Severe Hyponatremia: a Multicenter Open-label Randomized Controlled Trial

ICU patients with severe hyponatremia and a high risk of rapid SNa overcorrection.

Read the detailed description

Multicentre, prospective, open-label randomized controlled superiority trial with stratification on the presence of neurological symptoms at inclusion and on the presence/absence of risk factors for central pontine myelinolysis (chronic alcohol abuse, malnutrition, serum potassium < 3.0 mmol/L).

Patients in ICU with severe hyponatremia defined by SNa < 115 mmol/L or SNa < 120 mmol/L in the presence of neurological symptoms (convulsions, confusion defined by a Glasgow score <=14 or signs of brain herniation) and a normal or decreased extracellular fluid volume will be included.

After written informed consent, they will be randomized (1:1), using a computer-generated randomization scheme of various-sized blocks, stratified by the presence of neurological symptoms at inclusion (seizures, stupor defined as Glasgow score <=14 or signs of brain herniation) and on the presence/absence of risk factors for central pontine myelinolysis (chronic alcohol abuse [defined according to World Health Organization definition], malnutrition [BMI<20.5 or weight loss >5% in 3 months], serum potassium < 3.0 mmol/L), through a centralized 24-hour Internet service (CleanWEB™), to receive standard hyponatremic treatment alone or standard hyponatremic treatment and DDAVP 4 μg/ml IV, after randomisation and for a total duration of 48 hours. Since administration of DDAVP leads to an important decrease in urine output and increase in urine osmolarity which are clinically obvious very rapidly, a single or double blind trial is not appropriate. However, all investigators will be unaware of aggregate outcomes during the study and brain MRI imaging will be performed and analyzed blinded to the randomization group

Conditions
Hyponatremia
Being tested
DDAVP, Standard hyponatremia treatment
Medical subject headings
Hyponatremia

What participants receive

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

  • DDAVPDrug

    Posology: 4µg in 2ml IV solution Route of administration: Intravenous Duration of treatment: 48h maximum (additional doses every 6h)

  • Standard hyponatremia treatmentDrug

    Standard hyponatremia treatment alone :

    Presence of neurological symptoms :

    sodium chloride 3% 150ml for 20 min Absence of neurological symptoms : Hyper or isotonic fluid but never hypotonic

Study groups in NCT06020495
Study groupRoleWhat they receive
DDAVPExperimentalDDAVP 4µg/ml IV Additional doses may be administrated every 6h for a maximum of 48h - Standard hyponatremia treatment : Presence of neurological symptoms : sodium chloride 3% 150ml for 20 min Absence of neurological symptoms : Hyper or isotonic fluid but never hypotonic
Receives: Drug: DDAVP
Standard hyponatremia treatmentActive comparatorStandard hyponatremia treatment alone : Presence of neurological symptoms : sodium chloride 3% 150ml for 20 min Absence of neurological symptoms : Hyper or isotonic fluid but never hypotonic
Receives: Drug: Standard hyponatremia treatment

What is being measured

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

  1. reduced occurrence of overcorrection of serum sodium concentration (SNa) in the first 48 hours after randomization

    proportion of patients with SNa level overcorrection : any risk factor: SNa increase > 6 mmol/L in less than H24, or >12 mmol/L in less than H48. Without risk factor: SNa increase > 10 mmol/L in less than H24, or > 18 mmol/L in less than H48

    Measured: 48 hours after the randomization

Secondary outcomes (28)
  1. the reversal of acute neurological symptoms in patients with neurological symptoms at inclusion

    proportion of patients with neurological symptoms at inclusion and who subsequently have a normal Glasgow Coma Scale at H6

    Measured: 6 hours after the randomization

  2. ICU and hospital length of stay

    length of ICU and hospital stay

    Measured: ICU or hospital discharge

  3. survival

    time to death after inclusion

    Measured: death after randomization

  4. the occurrence of central pontine myelinolysis diagnosed on clinical and MRI criteria

    proportion of patients with the occurrence of central pontine myelinolysis diagnosed on clinical and MRI criteria at day 15 + 5 days (or earlier if clinically justified)

    Measured: 15 days + 5 days after randomization

  5. the occurrence of any (pontine or extrapontine) osmotic demyelination as assessed by brain MRI

    proportion of patients with any (pontine or extrapontine), symptomatic or not, osmotic demyelination as assessed by brain MRI at day 15 + 5 days (or earlier if clinically justified)

    Measured: 15 days + 5 days after randomization

  6. on the percentage of patients with neurological symptoms at inclusion and reaching the initial goal of rapid partial pre-defined correction of SNa level

    proportion of patients with neurological symptoms with an increase of 5.0 mmol/L or more of SNa from inclusion to H6

    Measured: 6 hours after the randomization

  7. the urine output between H0 and H6

    urine output between H0 and H6

    Measured: 6 hours after the randomization

  8. the urine output between H6 and H12

    urine output between H6 and H12

    Measured: 12 hours after the randomization

  9. the urine output between H12 and H24

    urine output between H12 and H24

    Measured: 24 hours after the randomization

  10. the urine output between H24 and H48

    urine output between H24 and H48

    Measured: 48 hours after the randomization

  11. the urine osmolality between H0 and H6

    urine osmolality between H0 and H6

    Measured: 6 hours after the randomization

  12. the urine osmolality between H6 and H12

    urine osmolality between H6 and H12

    Measured: 12 hours after the randomization

  13. the urine osmolality between H12 and H24

    urine osmolality between H12 and H24

    Measured: 24 hours after the randomization

  14. the urine osmolality between H24 and H48

    urine osmolality between H24 and H48

    Measured: 48 hours after the randomization

  15. SNa level correction rate between H0 and H24

    slope of the SNa increase between H0 and H24

    Measured: 24 hours after the randomization

  16. SNa level correction rate between H0 and H48

    slope of the SNa increase between H0 and H48

    Measured: 48 hours after the randomization

  17. the maximal change of SNa level between H0 and H24

    maximum change of SNa from baseline between H0 and H24

    Measured: 24 hours after the randomization

  18. the maximal change of SNa level between H0 and H48

    maximum change of SNa from baseline between H0 and H48

    Measured: 48 hours after the randomization

  19. the change of serum renin, apelin, Co-peptin and aldosterone concentration level between H0 and H6

    change of serum renin, apelin, Co-peptin and aldosterone concentrations from baseline H0 and H6

    Measured: 6 hours after the randomization

  20. the change of serum renin, apelin, Co-peptin and aldosterone concentration level between H6 and H24

    change of serum renin, apelin, Co-peptin and aldosterone concentrations from baseline H6 and H24

    Measured: between 6 and 24 hours after the randomization

  21. the change of serum renin, apelin, Co-peptin and aldosterone concentration level between H0 and H24

    change of serum renin, apelin, Co-peptin and aldosterone concentrations from baseline H0 and H24

    Measured: 24 hours after the randomization

  22. the change of serum renin, apelin, Co-peptin and aldosterone concentration level between H24 and H48

    change of serum renin, apelin, Co-peptin and aldosterone concentrations from baseline H24 and H48

    Measured: between 24 and 48 hours after the randomization

  23. amount of hypotonic fluids administration

    total amount of intravenous hypotonic fluids administered between H0 and H24

    Measured: 24 hours after the randomization

  24. amount of hypotonic fluids administration

    total amount of intravenous hypotonic fluids administered between H0 and H48

    Measured: 48 hours after the randomization

  25. amount of sodium and potassium administered between H0 and H24

    total amount of sodium and potassium administered between H0 and H24

    Measured: 24 hours after the randomization

  26. amount of sodium and potassium administered between H0 and H48

    total amount of sodium and potassium administered between H0 and H48

    Measured: 48 hours after the randomization

  27. the occurrence of any new neurological sign in relation with hyponatremia in patients with a normal neurological exam at inclusion or on the reappearance of any neurological sign in relation with hyponatremia after inclusion

    proportion of patients with seizures,confusion or sign of brain herniation appearing or reappearing after inclusion

    Measured: 28 days after randomization

  28. the occurrence of excessive re-lowering of sodium

    Occurrence of a reduction of SNa of 5.0 mmol/L or more from inclusion between H0 and H48

    Measured: 48 hours after the randomization

Timeline

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

  1. First posted31 Aug 2023
  2. Study start17 Dec 2024
  3. Primary completionDec 2027 (estimated)
  4. Study completionJan 2028 (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, prospective, open-label randomized controlled superiority trial with stratification on the presence of neurological symptoms at inclusion and on the presence/absence of risk factors for central pontine myelinolysis (chronic alcohol abuse, malnutrition, serum potassium \< 3.0 mmol/L).
Masking
None (open label)
Enrolment
260 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06020495
Sponsor's protocol ID
APHP220676
Acronym
DASSOH
Status last verified
Jul 2026
First submitted
28 Aug 2023
Last updated
30 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing DDAVP and Standard hyponatremia treatment in people with Hyponatremia, run by Assistance Publique - Hôpitaux de Paris at 15 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 4 inclusion and 22 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 30 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 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 GAUDRY Stéphane (01.48.95.55.55, stephane.gaudry@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

reduced occurrence of overcorrection of serum sodium concentration (SNa) in the first 48 hours after randomization (time frame: 48 hours after the randomization). 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 30 Oct 2026.

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