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Efficacy, safety and tolerability of AZD9977 and dapagliflozin in patients with heart failure and chronic kidney disease

Phase 2
Conditions
Heart Failure, Chronic Kidney Disease
Registration Number
JPRN-jRCT2031200272
Lead Sponsor
Hibi Kazushige
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
500
Inclusion Criteria

Documented diagnosis of stable symptomatic HF (New York Heart Association class II-III) at screening, and a medical history of typical symptoms and signs of HF in those who are currently receiving loop diuretic treatment

- Left ventricular ejection fraction <60% documented by the most recent echocardiogram or cardiac magnetic resonance imaging within the last 12 months prior to screening.

- Stable background treatment for HF, hypertension, diabetes mellitus or renal disease according to guidelines

- N-terminal-pro-brain natriuretic peptide (NT proBNP) 300 pg/mL or more for participants with sinus rhythm at screening; and NT proBNP 600 pg/mL or more for participants with atrial fibrillation/flutter at screening

- The eGFR 30 or more and 60 mL/min/1.73^2 (by CKD- EPI formula) or less and UACR >30 mg/g (3 mg/mmol) or more and <3000 mg/g (300 mg/mmol)

- Serum/plasma K+ level 3.5 or more and <5.0 mmol/L within 10 days prior to randomization

- Serum/ plasma Na+ level within normal reference values within 7 days prior to randomization

- Systolic blood pressure should be at protocol defined range at randomization (Visit 3), with no change to antihypertensive treatments in previous 3 weeks

- Body mass index less than 40 kg/m^2

- Male or female of non-childbearing potential

- All participants must follow protocol defined contraceptives procedures

Exclusion Criteria

- Primary glomerulopathy, vasculitic renal disease, prior dialysis or unstable rapidly progressing renal disease, autosomal dominant or autosomal recessive polycystic kidney disease, lupus nephritis or anti-neutrophil cytoplasm antibody -associated vasculitis

- Participants with currently decompensated HF requiring hospitalization for optimization of HF treatment and are not on stable HF therapy at the time of enrollment

- HF due to cardiomyopathies

- High output HF (e.g., due to hyperthyroidism or Paget's disease)

- HF due to pericardial disease, congenital heart disease or clinically significant uncorrected primary cardiac valvular disease or planned cardiac valve repair/replacement

- Participants with uncontrolled diabetes mellitus (Glycated hemoglobin >10%)

- Participants with Type 1 diabetes mellitus

- Intermittent or persistent 2nd or 3rd degree atrioventricular block, sinus node dysfunction with clinically significant bradycardia or sinus pauses, not treated with a pacemaker

- History of any life-threatening cardiac dysrhythmia or uncontrolled ventricular rate in participants with atrial fibrillation or atrial flutter

- Acute coronary syndrome and/or elective/non-elective percutaneous cardiac interventions (within 3 months) prior to randomisation or is planned to undergo any of these procedures during the study

- Any major cardiovascular (eg, open chest, coronary artery bypass grafting or valvular repair/replacement) or major non-cardiovascular surgery within 3 months prior to randomisation (Visit 3) or is planned to undergo any cardiovascular surgery during the study

- Heart transplantation or left ventricular assist device at any time or if these are planned

- Kidney or any organ transplantation or if these are planned

- Medical conditions associated with development of hyperkalaemia (Addison's disease )

- History or ongoing allergy/hypersensitivity, to sodium-glucose co-transporter-2 inhibitor (SGLT2i e.g., dapagliflozin, empagliflozin)

- Stroke, transient ischemic attack, carotid surgery, or carotid angioplasty within previous 3 months prior to randomisation

- Hepatic disease, including hepatitis and/or hepatic impairment (Child-Pugh class A-C), and aspartate aminotransferase or alanine transaminase or total bilirubin should be in protocol defined range at time of screening and/ or within 7 days prior to randomization

- Participants with newly detected pathological laboratory values or an ongoing disease condition

- If the participants clinical signs and symptoms consistent with COVID-19, and has been previously hospitalized with COVID-19 infection and did not fully recover their previous health status

- Previous randomization in the present study

- Prior medical treatment with an mineralocorticoid receptor antagonist where the medication was taken within 90 days prior to screening

- Current or prior treatment within 6 months prior to screening with cytotoxic therapy, immunosuppressive therapy, or other immunotherapy

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Percent change from baseline in UACR at 12 weeks [ Time Frame: Baseline (Day 1) until Week 12 (Day 85) ]<br>Evaluating the effect of AZD9977 in combination with dapagliflozin compared with dapagliflozin alone on UACR.
Secondary Outcome Measures
NameTimeMethod
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