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Heart Failure With Preserved Ejection FractionPhase 4EMPA-PREDNCT06249945

EMPAgliflozin in Heart Failure With PReserved Ejection Fraction and End Stage Renal Disease

A Phase 4 study testing Empagliflozin 25 MG in people with Heart Failure With Preserved Ejection Fraction and End Stage Renal Disease on Dialysis, run by National Taiwan University Hospital at 2 sites in Taiwan.

Recruiting

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

Sites and contacts
Official record
Search all trials

Trial summary

The presence of CKD has been linked to the development of HFpEF. Currently, the treatment for HFpEF is limited. SGLT2i are one of the few drug classes that have proven efficacy in HFpEF in randomized controlled trials. Read more about this study

Who is it for?
Ages 20 years and older
What is being tested?
Empagliflozin 25 MG
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
150 participants
Where
2 sitesTaiwan
Study dates
5 Mar 2024to 31 Dec 2030
Phase
Phase 4
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 20 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥20 years old
  • ESRD under chronic, maintenance dialysis with stable dry weight for the past 6 months
  • Prior diagnosis of HFpEF, as defined by a score of ≥5 on the HFA-PEFF diagnostic algorithm.

Who cannot join

  • Age <20 years old
  • Ongoing pregnancy
  • NYHA class IV heart failure
  • Any hospitalization for heart failure within the past month Ongoing acute urinary tract infection at the time of screening
  • Known acute genital infection
  • Severe peripheral artery disease (Rutherford category 4-6)
Show all 11Show fewer
  • Acute coronary syndrome, stroke or transient ischemic attack within the past month
  • Recent initiation of chronic maintenance hemodialysis within 6 months
  • Adjustment of dry weight with changes greater than 5% of body weight within the past month
  • Documented left ventricular ejection fraction =<40% by any imaging modality within 1 month of screening
  • Refused informed consent

Trial locations and contacts

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

Donna SH Lin, MD contact

+886912902379

Donna.lin24@gmail.com

Hao-Yun Lo, MD contact

+886972234640

limoonby@gmail.com

Taiwan2 sites, 2 recruiting
  • National Taiwan University Hospital Hsinchu Branch

    Hsinchu, 300

    Chih-Cheng Wu, PhD, 03 532 6151, chihchengwumd@gmail.com

    Chih-Cheng Wu, PhD

    Recruiting
  • Shin Kong Wu Ho-Su Memorial Hospital

    Taipei, 111

    Donna SH Lin, MD, 0912902379, donna.lin24@gmail.com

    Donna SH Lin, MD

    Recruiting

Other trials in Taiwan

About this study

Official title: The Safety and Efficacy of Empagliflozin in Patients With End-stage Renal Disease and Heart Failure With Preserved Ejection Fraction - a Randomized Controlled Trial

The presence of CKD has been linked to the development of HFpEF. Currently, the treatment for HFpEF is limited. SGLT2i are one of the few drug classes that have proven efficacy in HFpEF in randomized controlled trials. The results of mechanistic studies suggest that the benefits of SGLT2i on diastolic heart failure are independent of their glycosuric actions and may still be present in anuric subjects. Despite the significance of HFpEF in patients with CKD, patients with advanced kidney disease have been excluded from studies investigating anti-heart failure drugs. The effects of SGLT2i in patients under maintenance dialysis are largely unknown. Past pharmacokinetics and pharmacodynamics studies on empagliflozin in patients with end-stage renal disease (ESRD) demonstrated that the use of empagliflozin in patients with ESRD seemed safe, yet its efficacy remains to be explored.

Being tested
Empagliflozin 25 MG, Placebo
Keywords
end-stage renal disease, sodium-glucose co-transporter 2 inhibitors, heart failure, diastolic function, empagliflozin
Medical subject headings
Kidney Failure, Chronic, Heart Failure

What participants receive

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

  • Empagliflozin 25 MGDrug

    Also called Jardiance 25 MG

    The medication will be packed in a customized sealed jar and labeled on the exterior of the jar.

  • PlaceboDrug

    The placebo tablet is manufactured by Prince Pharmaceutical Co., Ltd, a leading manufacturer of nutritional supplements with certifications including cGMP, GMP, ISO, and HACCP. The Prince Pharmaceutical also provides Original Equipment Manufacturing (OEM)/Original Design Manufacturing (ODM) services for a wide array of tablet shapes, and post-processing techniques such as film coating and sugar coating.

Study groups in NCT06249945
Study groupRoleWhat they receive
empagliflozinExperimentalJardiance, 25 mg, QD, for 6 months
Receives: Drug: Empagliflozin 25 MG
PlaceboPlacebo comparatorQD, for 6 months
Receives: Drug: Placebo

What is being measured

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

  1. Mitral early (E) and late (A) diastolic filling velocity ratio (E/A)

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 24 weeks of treatment

Secondary outcomes (26)
  1. LV end-systolic volume index

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  2. LV end-diastolic volume index

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  3. LA volume index

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  4. LV ejection fraction

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  5. Left ventricular mass index

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  6. Global longitudinal strain

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  7. LA strain

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  8. Mitral inflow deceleration time

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  9. Mitral inflow deceleration time LV relative wall thickness

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  10. Tricuspid regurgitation peak gradient (TRPG)

    As assessed by echocardiography, performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  11. NT-proBNP

    Blood tests obtained pre-dialysis session

    Measured: 4 weeks, 12 weeks and 24 weeks of treatment

  12. HbA1c

    Blood tests obtained pre-dialysis session

    Measured: 4 weeks, 12 weeks and 24 weeks of treatment

  13. Lipid profile

    Blood tests obtained pre-dialysis session

    Measured: 4 weeks, 12 weeks and 24 weeks of treatment

  14. KCCQ-OS

    Performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  15. 6-minute walking distance

    Performed on non-dialysis day

    Measured: 12 weeks and 24 weeks of treatment

  16. 3-minute heart rate variability

    During hemodialysis session

    Measured: 12 weeks and 24 weeks of treatment

  17. Blood pressure

    Obtained pre-dialysis session

    Measured: 12 weeks and 24 weeks of treatment

  18. Major adverse cardiovascular events (composite of CV death, myocardial infarction, stroke)

    By medical record confirmation and by interview

    Measured: 24 weeks of treatment

  19. Lower extremity non-traumatic amputation or revascularization

    By medical record confirmation and by interview

    Measured: 24 weeks of treatment

  20. All-cause mortality

    By medical record confirmation and by interview

    Measured: 24 weeks of treatment

  21. Hospitalization for heart failure

    By medical record confirmation and by interview

    Measured: 24 weeks of treatment

  22. Hypoglycemic events

    By medical record confirmation and by interview

    Measured: 24 weeks of treatment

  23. Diabetic ketoacidosis

    By medical record confirmation and by interview

    Measured: 24 weeks of treatment

  24. Urinary tract infection

    By medical record confirmation and by interview

    Measured: 24 weeks of treatment

  25. Genital tract infection

    By medical record confirmation and by interview

    Measured: 24 weeks of treatment

  26. Hypokalemia

    Blood tests obtained pre-dialysis session

    Measured: 4 weeks, 12 weeks and 24 weeks of treatment

Timeline

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

  1. First posted8 Feb 2024
  2. Study start5 Mar 2024
  3. Primary completion31 Dec 2027 (estimated)
  4. Study completion31 Dec 2030 (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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06249945
Sponsor's protocol ID
202301126MINC
Acronym
EMPA-PRED
Status last verified
Nov 2024
First submitted
21 Jan 2024
Last updated
16 Dec 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020 Feb 29;395(10225):709-733. doi: 10.1016/S0140-6736(20)30045-3. Epub 2020 Feb 13.

    PubMed 32061315
  • Kalantar-Zadeh K, Jafar TH, Nitsch D, Neuen BL, Perkovic V. Chronic kidney disease. Lancet. 2021 Aug 28;398(10302):786-802. doi: 10.1016/S0140-6736(21)00519-5. Epub 2021 Jun 24.

    PubMed 34175022
  • Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J Am Coll Cardiol. 2008 Nov 4;52(19):1527-39. doi: 10.1016/j.jacc.2008.07.051.

    PubMed 19007588
  • Bansal N, Zelnick L, Bhat Z, Dobre M, He J, Lash J, Jaar B, Mehta R, Raj D, Rincon-Choles H, Saunders M, Schrauben S, Weir M, Wright J, Go AS; CRIC Study Investigators. Burden and Outcomes of Heart Failure Hospitalizations in Adults With Chronic Kidney Disease. J Am Coll Cardiol. 2019 Jun 4;73(21):2691-2700. doi: 10.1016/j.jacc.2019.02.071.

    PubMed 31146814
  • Kotecha D, Gill SK, Flather MD, Holmes J, Packer M, Rosano G, Bohm M, McMurray JJV, Wikstrand J, Anker SD, van Veldhuisen DJ, Manzano L, von Lueder TG, Rigby AS, Andersson B, Kjekshus J, Wedel H, Ruschitzka F, Cleland JGF, Damman K, Redon J, Coats AJS; Beta-Blockers in Heart Failure Collaborative Group. Impact of Renal Impairment on Beta-Blocker Efficacy in Patients With Heart Failure. J Am Coll Cardiol. 2019 Dec 10;74(23):2893-2904. doi: 10.1016/j.jacc.2019.09.059.

    PubMed 31806133
  • Ferro CJ, Mark PB, Kanbay M, Sarafidis P, Heine GH, Rossignol P, Massy ZA, Mallamaci F, Valdivielso JM, Malyszko J, Verhaar MC, Ekart R, Vanholder R, London G, Ortiz A, Zoccali C. Lipid management in patients with chronic kidney disease. Nat Rev Nephrol. 2018 Dec;14(12):727-749. doi: 10.1038/s41581-018-0072-9.

    PubMed 30361677
  • Shah KS, Fang JC. Is Heart Failure with Preserved Ejection Fraction a Kidney Disorder? Curr Hypertens Rep. 2019 Oct 10;21(11):86. doi: 10.1007/s11906-019-0993-0.

    PubMed 31599363
  • Ter Maaten JM, Damman K, Verhaar MC, Paulus WJ, Duncker DJ, Cheng C, van Heerebeek L, Hillege HL, Lam CS, Navis G, Voors AA. Connecting heart failure with preserved ejection fraction and renal dysfunction: the role of endothelial dysfunction and inflammation. Eur J Heart Fail. 2016 Jun;18(6):588-98. doi: 10.1002/ejhf.497. Epub 2016 Feb 10.

    PubMed 26861140
  • Cohen JB, Schrauben SJ, Zhao L, Basso MD, Cvijic ME, Li Z, Yarde M, Wang Z, Bhattacharya PT, Chirinos DA, Prenner S, Zamani P, Seiffert DA, Car BD, Gordon DA, Margulies K, Cappola T, Chirinos JA. Clinical Phenogroups in Heart Failure With Preserved Ejection Fraction: Detailed Phenotypes, Prognosis, and Response to Spironolactone. JACC Heart Fail. 2020 Mar;8(3):172-184. doi: 10.1016/j.jchf.2019.09.009. Epub 2020 Jan 8.

    PubMed 31926856
  • Anker SD, Butler J, Filippatos G, Ferreira JP, Bocchi E, Bohm M, Brunner-La Rocca HP, Choi DJ, Chopra V, Chuquiure-Valenzuela E, Giannetti N, Gomez-Mesa JE, Janssens S, Januzzi JL, Gonzalez-Juanatey JR, Merkely B, Nicholls SJ, Perrone SV, Pina IL, Ponikowski P, Senni M, Sim D, Spinar J, Squire I, Taddei S, Tsutsui H, Verma S, Vinereanu D, Zhang J, Carson P, Lam CSP, Marx N, Zeller C, Sattar N, Jamal W, Schnaidt S, Schnee JM, Brueckmann M, Pocock SJ, Zannad F, Packer M; EMPEROR-Preserved Trial Investigators. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021 Oct 14;385(16):1451-1461. doi: 10.1056/NEJMoa2107038. Epub 2021 Aug 27.

    PubMed 34449189
  • Verma S, Mazer CD, Yan AT, Mason T, Garg V, Teoh H, Zuo F, Quan A, Farkouh ME, Fitchett DH, Goodman SG, Goldenberg RM, Al-Omran M, Gilbert RE, Bhatt DL, Leiter LA, Juni P, Zinman B, Connelly KA. Effect of Empagliflozin on Left Ventricular Mass in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease: The EMPA-HEART CardioLink-6 Randomized Clinical Trial. Circulation. 2019 Nov 19;140(21):1693-1702. doi: 10.1161/CIRCULATIONAHA.119.042375. Epub 2019 Aug 22.

    PubMed 31434508
  • Ersboll M, Jurgens M, Hasbak P, Kjaer A, Wolsk E, Zerahn B, Brandt-Jacobsen NH, Gaede P, Rossing P, Faber J, Inzucchi SE, Gustafsson F, Schou M, Kistorp C. Effect of empagliflozin on myocardial structure and function in patients with type 2 diabetes at high cardiovascular risk: the SIMPLE randomized clinical trial. Int J Cardiovasc Imaging. 2022 Mar;38(3):579-587. doi: 10.1007/s10554-021-02443-5. Epub 2021 Oct 20.

    PubMed 34669059
  • Soga F, Tanaka H, Tatsumi K, Mochizuki Y, Sano H, Toki H, Matsumoto K, Shite J, Takaoka H, Doi T, Hirata KI. Impact of Dapagliflozin on the Left Ventricular Diastolic Function in Diabetic Patients with Heart Failure Complicating Cardiovascular Risk Factors. Intern Med. 2021;60(15):2367-2374. doi: 10.2169/internalmedicine.6127-20. Epub 2021 Aug 1.

    PubMed 34334588
  • Li X, Lu Q, Qiu Y, do Carmo JM, Wang Z, da Silva AA, Mouton A, Omoto ACM, Hall ME, Li J, Hall JE. Direct Cardiac Actions of the Sodium Glucose Co-Transporter 2 Inhibitor Empagliflozin Improve Myocardial Oxidative Phosphorylation and Attenuate Pressure-Overload Heart Failure. J Am Heart Assoc. 2021 Mar 16;10(6):e018298. doi: 10.1161/JAHA.120.018298. Epub 2021 Mar 13.

    PubMed 33719499
  • Pabel S, Wagner S, Bollenberg H, Bengel P, Kovacs A, Schach C, Tirilomis P, Mustroph J, Renner A, Gummert J, Fischer T, Van Linthout S, Tschope C, Streckfuss-Bomeke K, Hasenfuss G, Maier LS, Hamdani N, Sossalla S. Empagliflozin directly improves diastolic function in human heart failure. Eur J Heart Fail. 2018 Dec;20(12):1690-1700. doi: 10.1002/ejhf.1328. Epub 2018 Oct 17.

    PubMed 30328645

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Empagliflozin 25 MG in people with Heart Failure With Preserved Ejection Fraction and End Stage Renal Disease on Dialysis, run by National Taiwan University Hospital at 2 sites in Taiwan.

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 11 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 16 Dec 2024. 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 Taiwan. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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 Donna SH Lin, MD (+886912902379, Donna.lin24@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mitral early (E) and late (A) diastolic filling velocity ratio (E/A) (time frame: 24 weeks of treatment). 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 NCT06249945, which also lists 22 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 16 Dec 2024.

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