A 6-Month, Randomized, Double-Blind Study to Evaluate the Effect of Dapagliflozin on EChOcardiographic Measures of CarDiac StructurE and Function in Patients with Chronic Kidney Disease
Overview
- Phase
- Phase 2
- Intervention
- Dapagliflozin 10 mg
- Conditions
- Chronic Kidney Diseases
- Sponsor
- Tor Biering-Sørensen
- Enrollment
- 222
- Locations
- 1
- Primary Endpoint
- Change in LV mass index assessed by echocardiography at 6 months
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
The purpose of this study is to investigate the effects of dapagliflozin on echocardiographic measures of cardiac structure and function in patients with chronic kidney disease.
Detailed Description
The study is a 6-month, investigator-initiated, randomized, double-blind, placebo-controlled clinical trial to evaluate the effects of dapagliflozin on echocardiographic measures of cardiac structure and function in patients with chronic kidney disease. The study population will consist of approximately 222 adults with chronic kidney disease - defined as a glomerular filtration rate (GFR) of 20-60 mL/min/1.73m2, in treatment with maximally tolerated ACEi or ARB. Patients will be randomized to either 10 mg dapagliflozin or placebo. Patients will be assessed by measurement of echocardiography, pulse wave velocity, blood samples, urine samples, quality of life, depressive symptoms, and cognitive function at baseline and after 6 months of treatment.
Investigators
Tor Biering-Sørensen
Research Director, MD, PhD, MPH
Herlev and Gentofte Hospital
Eligibility Criteria
Inclusion Criteria
- •Signed informed consent
- •≥ 18 years of age
- •Chronic kidney disease (CKD), defined as evidence of decreased eGFR (eGFR ≥20 and \<60 mL/minute per 1.73 m2) or between eGFR ≥60 and \<90 mL/minute per 1.73 m2 with urinary albumin:creatinine ratio ≥200 mg/g or protein:creatinine ratio ≥300 mg/g
- •Stable treatment with clinically appropriate doses of ACEi/ARB among CKD patients with proteinuria and uptitrated to maximal recommended or tolerated dose for at least 4 weeks before randomization, if not medically contraindicated
- •For patients with type 2 diabetes:
- •Stable antihyperglycemic treatment \> 30 days before screening
- •Female patients should either not be of childbearing potential, defined as postmenopausal for at least 1 year or surgically sterile, or is of childbearing potential and practicing one of the following methods of contraception throughout the study and for 30 days after study completion: Hormonal contraception (oral contraceptives, contraceptive implant, injectable birth control, contraceptive patch, or vaginal ring) or intrauterine device
- •Ability to understand and read Danish
Exclusion Criteria
- •Type 1 diabetes
- •For patients with type 2 diabetes:
- •History of diabetic ketoacidosis
- •Patients undergoing dialysis
- •History of organ transplant
- •Treatment with SGLT2 inhibitor within 8 weeks prior to enrolment
- •Known allergy or hypersensitivity to SGLT2 inhibitors or Placebo ingredients
- •Myocardial infarction, unstable angina, stroke or transient ischemic attack within 12 weeks of enrolment
- •Coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting) or valvular repair/replacement within 12 weeks prior to enrolment
- •Any condition outside the renal and cardiovascular study area with a life expectancy of \<2 years based on investigator's clinical judgement
Arms & Interventions
Dapagliflozin 10 mg once daily
Intervention: Dapagliflozin 10 mg
Placebo once daily
Intervention: Placebo
Outcomes
Primary Outcomes
Change in LV mass index assessed by echocardiography at 6 months
Time Frame: 6 months
Secondary Outcomes
- Change in hemoglobin at 6 months(6 months)
- Change in LV end-diastolic volume at 6 months(6 months)
- Change in N-terminal pro B-type natriuretic peptide (NT-pro-BNP) at 6 months(6 months)
- Change in estimated glomerular filtration rate (eGFR) 6 months(6 months)
- Change in urinary albumin-to-creatinine ratio (UACR) at 6 months(6 months)
- Change in LVEF assessed by echocardiography at 6 months(6 months)
- Change in GLS assessed by echocardiography at 6 months(6 months)
- Change in LV mass assessed by echocardiography at 6 months(6 months)
- Change in LV end-systolic volume at 6 months(6 months)
- Change in LA volume index assessed by echocardiography at 6 months(6 months)
- Change in high sensitivity troponin I (hs-TNI) at 6 months(6 months)