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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01398371
Registration number
NCT01398371
Ethics application status
Date submitted
19/07/2011
Date registered
20/07/2011
Date last updated
1/06/2016
Titles & IDs
Public title
Digoxin Withdrawal in Stable Heart Failure
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Scientific title
A Randomised, Blinded, Placebo Controlled Trial to Assess the Effect of Digoxin Withdrawal in Stable Heart Failure Patients Receiving Optimal Background Therapy
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Secondary ID [1]
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Pending
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Secondary ID [2]
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257/11
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Heart Failure
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Condition category
Condition code
Cardiovascular
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Coronary heart disease
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Cardiovascular
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Withdrawal of digoxin
Treatment: Drugs - Digoxin
Active comparator: Stable digoxin therapy - Participants need to have been receiving digoxin therapy for at least 3 months at a dose that results in digoxin plasma levels of 0.4-0.8 on 2 consecutive blood tests (at least 1 weeks apart) prior to randomisation. The dose of digoxin must remain stable for at least 2 weeks prior to randomisation.
Experimental: Digoxin withdrawal - Participants will receive a placebo for 4 weeks.
Treatment: Drugs: Withdrawal of digoxin
Participants currently receiving digoxin for heart failure will have their digoxin stopped for 12 weeks.
Treatment: Drugs: Digoxin
Stable digoxin therapy which produces a digoxin plasma level of 0.4-0.8.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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NYHA Heart Failure class
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Assessment method [1]
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Timepoint [1]
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after 12 wks of treatment
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Secondary outcome [1]
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6 minute walk test
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Assessment method [1]
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Timepoint [1]
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after 12 wks of treatment
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Secondary outcome [2]
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Quality of Life
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Assessment method [2]
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Standard questionnaires will be used
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Timepoint [2]
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After 12 weeks of treatment
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Secondary outcome [3]
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Change in BNP
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Assessment method [3]
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Timepoint [3]
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After 12 weeks of treatment
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Eligibility
Key inclusion criteria
1. Over the age of 18 years
2. In sinus rhythm at the time of randomisation
3. Have a LVEF <0.45 and a left ventricular end-diastolic dimension >60 mm or >34 mm/m2
4. Are receiving ACE inhibitor, ß-blocker and diuretic therapy at the optimal doses.
5. Has been receiving digoxin therapy for at least 3 months at a dose that results in digoxin plasma levels of 0.4-0.8 on 2 consecutive blood tests (at least 1 weeks apart) prior to randomisation. The dose of digoxin must remain stable for at least 2 weeks prior to randomisation.
6. Documented, stable heart failure. Must have at least 1 of the following:
* Hospitalised with a discharge diagnosed of heart failure in the last 6 months
* Evidence of pulmonary congestion on chest X-ray
* Evidence of heart failure on echocardiogram
* Evidence of heart failure on ECG
7. Willing and able to provide informed consent
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Systolic BP >160mmHg or <90mmHg
2. Diastolic BP >95mmHg
3. Uncorrected primary valvular disease
4. Active myocarditis
5. Obstructive or restrictive Cardiomyopathy
6. Exercise capacity limited by other factors not including dyspnoea
7. Myocardial infarction within the previous 6 months
8. Stroke within the previous 12 months
9. Hospitalisation within one month of randomisation
10. A history of supraventricular arrhythmia or sustained ventricular arrhythmia
11. Claudication
12. Severe primary pulmonary (VC <1.5L), renal or hepatic disease
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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Intervention assignment
Crossover
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/08/2011
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/06/2015
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Sample size
Target
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Accrual to date
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Final
16
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Clinical Pharmacology, Alfred Hospital - Melbourne
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Recruitment postcode(s) [1]
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3004 - Melbourne
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Funding & Sponsors
Primary sponsor type
Other
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Name
The Alfred
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
Heart failure is a chronic condition in which the heart fails to function as a pump to move blood around the body. This sets up a complex physiologic response to compensate, which include activation of many hormonal mechanisms which result in fluid accumulation. In recent years, medications to block the hormonal response to heart failure are given as standard drugs, and these include ACE inhibitors, and beta blockers. Mortality is reduced with these medications, as well as symptoms improved. Medications that were traditionally used in heart failure include diuretics, which cause fluid loss, and digoxin, which causes the heart to pump harder. These medications were introduced before clinical trials as we know them now were run. Since the introduction of ACE inhibitors and beta blockers, it is not clear whether there is still a role for digoxin. In this study, we plan to withdraw digoxin from patients with stable heart failure in normal rhythm, taking stable doses of ACE inhibitors and beta blockers, in a closely monitored environment and watch for the effect of this on heart failure.
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Trial website
https://clinicaltrials.gov/study/NCT01398371
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Henry Krum, MBBS, FRACP, PhD
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Address
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Alfred Hospital / Monash University
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT01398371
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