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Trial registered on ANZCTR
Registration number
ACTRN12618000795291
Ethics application status
Approved
Date submitted
29/03/2018
Date registered
10/05/2018
Date last updated
22/01/2019
Date data sharing statement initially provided
22/01/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Effects of Sodium Glucose Co-Transpoter-2 (SGLT-2) in diabetics with heart failure
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Scientific title
Effects of Sodium Glucose Co-Transporter-2 (SGLT-2) on self-reported symptoms and serum biomarkers in patients with diabetes and heart failure.
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Secondary ID [1]
294469
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nil known
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Universal Trial Number (UTN)
U1111-1211-5199
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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
307230
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Type 2 Diabetes
307231
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Condition category
Condition code
Cardiovascular
306343
306343
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0
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Other cardiovascular diseases
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Metabolic and Endocrine
306344
306344
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0
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Diabetes
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
The aim of this study is to test the hypothesis that treatment with sodium-glucose co-transporter 2(SGLT-2) inhibitors will decrease the risk, progression and severity of heart failure and also if there is any benefit in the quality of life in these patients following the addition of a SGLT-2 inhibitor to standard medical care.
Exposure:
The patients will be recruited from the Endocrinology Clinics at Eastern Health - Box Hill Hospital and Maroondah Hospital. All patients meeting the inclusion criteria will have medical history and physical examination performed, baseline blood tests and functional status as assessed by the Minnesota Living with Heart failure questionnaire. SGLT-2 inhibitors (dapaglifozin or empaglifozin) will be started in the course of normal clinical practice and according to exisiting guidelines. The SGLT-2 inhibitor will be added to additional therapy or substituted for additional therapy at the discretion of the treating physician.
They will be followed up over the period of 6 months and the blood tests will be repeated. The quality of life will be assessed again using the Minnesota Living with Heart failure questionnaire.
The blood tests include: hsCRP, troponin, BNP, HbA1c
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Intervention code [1]
300762
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Not applicable
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Comparator / control treatment
No Control group.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Change in the cardiac function as a composite outcome of changes in serum biomarkers - troponin, high sensitivity CRP(hsCRP) and brain natriuretic peptide(BNP) levels
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Assessment method [1]
305355
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Timepoint [1]
305355
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6 months from time of initiation of SGLT-2 inhibitor.
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Secondary outcome [1]
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Change in self reported symptoms as assessed by changes in the scores for Minnesota Living with Heart Failure Questionnaire.
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Assessment method [1]
344937
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Timepoint [1]
344937
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6 months from time of initiation of SGLT-2 inhibitor.
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Secondary outcome [2]
344938
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Change in functional class as assessed by changes in NYHA functional class
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Assessment method [2]
344938
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Timepoint [2]
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6 months from time of initiation of SGLT-2 inhibitor.
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Secondary outcome [3]
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Change in serum troponin
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Assessment method [3]
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Timepoint [3]
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6 months from time of initiation of SGLT-2 inhibitor.
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Secondary outcome [4]
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Change in hsCRP measured by serum assay.
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Assessment method [4]
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Timepoint [4]
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6 months from time of initiation of SGLT-2 inhibitor.
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Secondary outcome [5]
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Change in BNP measured by serum assay
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Assessment method [5]
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Timepoint [5]
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6 months from time of initiation of SGLT-2 inhibitor.
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Eligibility
Key inclusion criteria
- Patients aged between 18 and 85 with established heart failure (New York Heart Association Class II, III, IV) AND
- Receiving treatment for type 2 diabetes mellitus with metformin, a sulphonylurea, a dual oral therapy, a combination of insulin and oral agents or insulin alone in cases where oral antidiabetic medications are contraindicated.
- The HbA1c measurements of participants should be greater than 7.0% and obtained within the preceding 4 months.
- Endocrinology team have assessed and deemed the patient suitable to be commenced on SGLT-2 inhibitors as per current guidelines.
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Minimum age
18
Years
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Maximum age
85
Years
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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
- Patients with type 1 diabetes mellitus, stage 3B, 4 and 5 chronic kidney disease (including patients on dialysis), galactose intolerance and a history of alcohol misuse, ketoacidosis or recurrent genitourinary infections.
- Patients already receiving treatment with a dipeptidyl peptidase 4 inhibitor, thiazolidinedione or a glucagon-like peptide-1 .
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
The Minnesota Living with Heart Failure Questionnaire scores of participants at baseline and 6 months from the commencement of a SGLT-2 inhibitor would be analysed using the Wilcoxon test. Analysis of serum biomarker levels may be performed with a paired t-test given the small intended sample size for this study.
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Recruitment
Recruitment status
Stopped early
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Data analysis
No data analysis planned
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Reason for early stopping/withdrawal
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
15/05/2018
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Actual
21/05/2018
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Date of last participant enrolment
Anticipated
30/11/2018
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Actual
8/08/2018
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Date of last data collection
Anticipated
31/05/2019
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Actual
8/08/2018
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Sample size
Target
40
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Accrual to date
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Final
2
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
10523
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Box Hill Hospital - Box Hill
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Recruitment hospital [2]
10524
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Maroondah Hospital - Ringwood East
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Recruitment postcode(s) [1]
22238
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3128 - Box Hill
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Recruitment postcode(s) [2]
22239
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3135 - Ringwood East
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Funding & Sponsors
Funding source category [1]
299091
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Hospital
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Name [1]
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Endocrinology Department, Box Hill Hospital - Eastern Health
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Address [1]
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5 Arnold Street, Box Hill. VIC 3128
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Country [1]
299091
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Australia
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Primary sponsor type
Hospital
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Name
Endcrinology Department, Box Hill Hospital - Eastern Health
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Address
5 Arnold Street, Box Hill. VIC 3128
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Country
Australia
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Secondary sponsor category [1]
298344
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None
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Name [1]
298344
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Address [1]
298344
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Country [1]
298344
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
300028
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Human Research Ethics Committee - Scientific and Ethical Review. Eastern Health
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Ethics committee address [1]
300028
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Level 2, 5 Arnold Street, Box Hill. VIC 3128
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Ethics committee country [1]
300028
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Australia
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Date submitted for ethics approval [1]
300028
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13/01/2018
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Approval date [1]
300028
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13/02/2018
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Ethics approval number [1]
300028
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LR06-2018
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Summary
Brief summary
Background: Patients with type 2 diabetes mellitus area at a higher risk of developing heart failure and a significant number of patients with established heart failure are receiving treatment for type 2 diabetes mellitus. The EMPA-REG OUTCOME study concluded that the inclusion of empagliflozin in the treatment received by patients with a high risk for cardiovascular events reduced the rate of primary adverse cardiovascular outcomes and mortality. Aim: The aim of this study is to test the hypothesis that treatment with sodium-glucose co-transporter 2(SGLT-2) inhibitors will decrease the risk, progression and severity of heart failure and also if there is any benefit in the quality of life in these patients following the addition of a SGLT-2 inhibitor as part of standard medical care. Methods: Participants will be recruited from the diabetes clinics at Box Hill and Maroondah Hospitals. These patients will have been identified by their treating physicians as suitable for SGLT-2 inhibitors. The SGLT-2 inhibitors (dapaglifozin or ertuglifozin) will be started in the course of normal clinical practice and according to existing clinical guidelines. The SGLT-2 inhibitor will be added to additional therapy or substituted for additional therapy at the discretion of the treating physician. Baseline blood tests and a Living with Heart failure questionnaire will be completed by the patients. Treatment will be monitored and further changes to therapy, the addition of other agents or the discontinuation of other agents, including SGLT-2 inhibitors, will also be at the discretion of the treating physician. Audit information will be collected prospectively but no information will be collected that is not a normal part of clinical practice in patients with heart failure. Recruitment of the participants will be by the registrars/consultants from the diabetes clinics after a thorough discussion about the safety of SGLT2 inhibitors and with full consent by the patient.
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Trial website
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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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Prof Chris Gilfillan
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Address
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Department of Endocrinology- Eastern Health, Level 2, 5 Arnold Street. Box Hill VIC 3128
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Country
82310
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Australia
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Phone
82310
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+61 3 90926753
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Fax
82310
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Email
82310
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[email protected]
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Contact person for public queries
Name
82311
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Shananthan Balachandran
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Address
82311
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Department of General Medicine - Eastern Health. 5 Arnold Street, Box Hill VIC 3128
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Country
82311
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Australia
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Phone
82311
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+61 3 9895 3128
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Fax
82311
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Email
82311
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[email protected]
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Contact person for scientific queries
Name
82312
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Harsh Thakkar
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Address
82312
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Department of General Medicine - Eastern Health. 5 Arnold Street, Box Hill VIC 3128
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Country
82312
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Australia
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Phone
82312
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+61 3 9895 3128
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Fax
82312
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Email
82312
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Adequate participants haven't been recruited hence data will not be stored.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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