Aortic StenosisPhase 2/3DAPASNCT05241431
Effect of Dapagliflozin on Myocardial and Renal Function Following Aortic Valve Stenosis Intervention
A Phase 2/3 study testing SGLT2 inhibitor in people with Aortic Stenosis and Left Ventricle Hypertrophied, run by University of Aarhus at 1 site in Denmark.
Trial summary
Randomized, double-blinded, placebo-controlled study in AS patients with subclinical or clinical heart failure undergoing treatment with TAVR. Read more about this study
- Who is it for?
- Ages 18 to 85 years
- Conditions the study is for
- Aortic Stenosis, Left Ventricle Hypertrophied
- What is being tested?
- SGLT2 inhibitor
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 106 participants
- Where
- 1 siteDenmark
- Study dates
- 12 Feb 2022to 1 Apr 2024
- Phase
- Phase 2/3
- Are there results?
- None posted in the registry
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 18 to 85 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Signed informed consent
- Scheduled TAVR for significant symptomatic AS according to current guidelines
- Age ≥ 18 years and < 85 years.
- *
- LVEF ≥ 40% and ≤ 50 % or LVEF ≥ 50% with at least one of the following:
- LV GLS ≤ 15% by TTE
Show all 9Show fewer
- LV septum or posterior wall thickness ≥ 12mm by TTE or LV mass index ≥108/131 g/m2 for females/males (mild LVH)
- LVEF ≥ 50 % and Nt-proBNP > 600/900 ng/l (sinus rhythm/atrial fibrillation)
- eGFR > 30 mL/min/1.73 m2
Who cannot join
- Medically treated type 1 or type 2 diabetes mellitus
- Ongoing treatment with an SGLT2-inhibitor or intolerance to SGLT2-inhibitors
- Life expectancy < 12 months
- Symptomatic hypotension or persistent SBP < 100 mmHg
- Contraindications to CMRI
- HF due to restrictive or infiltrative cardiomyopathy, active myocarditis, constrictive pericarditis or hypertrophic obstructive cardiomyopathy
Show all 12Show fewer
- Additional other untreated severe valvular disease
- Liver failure
- Women who are pregnant or plan to be within the study period.
- Allergy to any substance in the project medicine, both placebo and active medicine.
- Previous renal transplantation.
- Chronic dialysis treatment.
Trial locations and contacts
1 site in 1 country.
Denmark1 site, 1 recruiting
- Recruiting
Aarhus University Hospital
Aarhus, 8200
Anders Lehmann Dahl Pedersen, MD
About this study
Randomized, double-blinded, placebo-controlled study in AS patients with subclinical or clinical heart failure undergoing treatment with TAVR.
Read the detailed description
This is a randomized, double-blinded, placebo-controlled study in AS patients with subclinical or clinical heart failure undergoing treatment with TAVR. It evaluates the effect of Dapagliflozin versus placebo, given once daily in addition to background standard medical therapy. Patients who are scheduled for TAVR at Aarhus University Hospital (AUH) will be informed about the project and invited to participate if they fulfill the inclusion criteria prior to the TAVR procedure.
Patients will be randomized 1:1 in blocks of 6 patients to either Dapagliflozin 10 mg daily or placebo within 1 months prior to the scheduled TAVR therapy.
The total treatment period is 13 months with 6 scheduled outpatient clinic visits at baseline (before TAVR) and at 1, 3, 6, 9, 12 months after TAVR.
Cardiac magnetic resonance imaging (CMRI) is performed at baseline and 12 months follow-up. Echocardiography is performed at baseline, 1- and 12 months. 24-hour ambulatory blood pressure is measured at baseline and 12-months post-TAVR. Clinical status, HF questionnaire and blood samples will be performed at each visit. Drug accountability and adherence to the protocol is evaluated at each visit.
A sub study in 40 of the included patients (20 treated with Dapagliflozin and 20 placebo) is planned. This will include additional endomyocardial biopsies taken at baseline and 12-months follow-up for high resolution respirometry (mitochondrial function) and electron microscopy (mitochondrial structure and interstitial fibrosis) supplemented by right heart catherization (RHC) for hemodynamic assessment.
- Conditions
- Aortic Stenosis, Left Ventricle Hypertrophied
- Being tested
- SGLT2 inhibitor, Placebo
- Medical subject headings
- Aortic Valve Stenosis, Hypertrophy, Left Ventricular
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SGLT2 inhibitorDrug
10 mg orally once daily in addition to standard medical treatment.
PlaceboDrug
Placebo tablets similar to active treatment.
| Study group | Role | What they receive |
|---|---|---|
| Intervention group | Active comparator | 10 mg (oral) SGLT-2 inhibitor once daily Receives: Drug: SGLT2 inhibitor |
| Control group | Placebo comparator | Placebo tablet encapsulated as the active treatment. Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Composite endpoint of changes in LV mass, systolic function, eGFR, and serum Nt-proBNP
Changes from baseline to 12 months of follow-up in at least 2 out of 4 well-known parameters is required to reach the primary endpoint:
- LVMi (grams) reduction of 10 % point (by CMRI)
- LV GLS (percent) absolute increase of 2.0 % point (by TTE)
- A decrease in serum Nt-proBNP (ng/L) of more than 25%
- Relative increase of 10% in eGFR (ml/min/1.73m^2) If 2 or more of the 4 outcome measures are reached at 12-months follow-up, the patient has fulfilled the primary end-point.
Measured: Baseline assesment to 12-months follow-up post-TAVR
Secondary outcomes (17)
Difference in the change in eGFR
Difference between active treatment and placebo at 12-months follow-up
Measured: baseline to 12-months
Difference in eGFR
Difference between active treatment and placebo at 12-months follow-up
Measured: 12-months
The number of patients with a relative difference of 10 % of myocardial interstitial fibrosis evaluated by the biomarker extracellular volume (ECV) by late enhancement gadolinium by CMR
Difference between active treatment and placebo.
Measured: Baseline to 12-months
The number of patients with a >10% decrease in cardiac fibrosis when assessed by histology and quantified by stereology (sub study)
Difference between active treatment and placebo.
Measured: Baseline to 12-months
The number of patients with an increase in the respiratory control ratio (RCR) by ≥10% measured by High Resolution Respirometry (HRR) (sub study)
Difference between active treatment and placebo.
Measured: Baseline to 12-months
Composite endpoint of worsening HF with hospitalization or urgent outpatient clinical visit due to HF, and all-cause mortality.
Difference between active treatment and placebo in the incidence rate of hospitalization due to worsening heart failure or urgent clinical visit due to heart failure and all-cause mortality (using dates of the events to assess the incidence rates in the two groups: active treatment and placebo.
Measured: 12-months post-TAVR
All-cause mortality
Difference between active treatment and placebo.
Measured: Baseline to 12-months post-TAVR
Worsening HF with hospitalization or urgent outpatient clinical visit due to HF
Difference between active treatment and placebo.
Measured: 12-months post-TAVR
Difference in the change in urinary albumin/creatinine ratio
Difference between active treatment and placebo.
Measured: Baseline to 12-months
Difference in ACR at 12-months follow-up
Difference between active treatment and placebo.
Measured: 12-months follow-up
24-hour ambulatory blood pressure changes
Difference between active treatment and placebo in both systolic and diastolic blood pressure.
Measured: baseline to 12 months
Change from baseline to 12-months follow-up in the Kansas City Cardiomyopathy questionnaire
Change from baseline in KCCQ will be reported. The KCCQ is a 23-item, self-administered questionnaire with score range of 0 to 100, and higher scores indicating better health. Difference in score for active treatment vs. placebo.
Measured: Baseline to 12-months
Change from baseline to 12-months follow-up in New York Heart Association-class (NYHA)
The NYHA functional classification categorizes the extent of heart failure by placing subjects in one of four (I, II, III, IV) categories based on how much they are limited during physical activity and symptoms of shortness of breath and/or angina. Shift in NYHA-class between active treatment group and placebo.
Measured: baseline to 12-months.
LVMi reduction of 10 % point (by CMRI)
Difference between active treatment and placebo.
Measured: baseline to 12-months.
LV GLS absolute increase of 2.0 % point (by TTE)
Difference between active treatment and placebo.
Measured: Baseline to 12-months follow-up
A decrease in serum Nt-proBNP of more than 25% follow-up
Difference between active treatment and placebo.
Measured: baseline to 12-months follow-up.
Relative increase of 10% in eGFR
Difference between active treatment and placebo.
Measured: Baseline to 12-months follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Feb 2022
- Study start12 Feb 2022
- Primary completion1 Mar 2024 (estimated)
- Study completion1 Apr 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Aortic StenosisStudies of the same condition, open and under way.
- More trials run by University of AarhusThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 2/3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 106 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Aarhus
- Sponsor type
- University, hospital or other
- Collaborators
- Aarhus University Hospital
- Responsible party
- Sponsor
- Investigators
- Steen Hvitfeldt Poulsen, Principal investigator, Aarhus University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05241431
- Sponsor's protocol ID
- DAPAS
- Acronym
- DAPAS
- Status last verified
- Jan 2022
- First submitted
- 18 Jan 2022
- Last updated
- 15 Feb 2022
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 15 Feb 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Dapagliflozin on Myocardial and Renal Function Following Aortic Valve Stenosis Intervention
- ClinicalTrials.gov ID
- NCT05241431
- Acronym / sponsor ID
- DAPAS / DAPAS
- Conditions
- Aortic Stenosis, Left Ventricle Hypertrophied
- Phase
- Phase 2/3
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 106 participants (estimated)
- Lead sponsor
- University of AarhusUniversity, hospital or other
- Collaborators
- Aarhus University Hospital
- Study start
- 12 Feb 2022 (actual)
- Primary completion
- 1 Mar 2024 (estimated)
- Study completion
- 1 Apr 2024 (estimated)
- First posted
- 15 Feb 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Randomized, double-blinded, placebo-controlled study in AS patients with subclinical or clinical heart failure undergoing treatment with TAVR.
Detailed description
This is a randomized, double-blinded, placebo-controlled study in AS patients with subclinical or clinical heart failure undergoing treatment with TAVR. It evaluates the effect of Dapagliflozin versus placebo, given once daily in addition to background standard medical therapy. Patients who are scheduled for TAVR at Aarhus University Hospital (AUH) will be informed about the project and invited to participate if they fulfill the inclusion criteria prior to the TAVR procedure.
Patients will be randomized 1:1 in blocks of 6 patients to either Dapagliflozin 10 mg daily or placebo within 1 months prior to the scheduled TAVR therapy.
The total treatment period is 13 months with 6 scheduled outpatient clinic visits at baseline (before TAVR) and at 1, 3, 6, 9, 12 months after TAVR.
Cardiac magnetic resonance imaging (CMRI) is performed at baseline and 12 months follow-up. Echocardiography is performed at baseline, 1- and 12 months. 24-hour ambulatory blood pressure is measured at baseline and 12-months post-TAVR. Clinical status, HF questionnaire and blood samples will be performed at each visit. Drug accountability and adherence to the protocol is evaluated at each visit.
A sub study in 40 of the included patients (20 treated with Dapagliflozin and 20 placebo) is planned. This will include additional endomyocardial biopsies taken at baseline and 12-months follow-up for high resolution respirometry (mitochondrial function) and electron microscopy (mitochondrial structure and interstitial fibrosis) supplemented by right heart catherization (RHC) for hemodynamic assessment.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Intervention group | Active comparator | Drug: SGLT2 inhibitor10 mg (oral) SGLT-2 inhibitor once daily |
| Control group | Placebo comparator | Drug: PlaceboPlacebo tablet encapsulated as the active treatment. |
Who may qualify
- Ages
- 18 to 85 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (9 listed)
- Signed informed consent
- Scheduled TAVR for significant symptomatic AS according to current guidelines
- Age ≥ 18 years and < 85 years.
- *
- eGFR > 30 mL/min/1.73 m2
Key exclusion criteria (12 listed)
- Medically treated type 1 or type 2 diabetes mellitus
- Ongoing treatment with an SGLT2-inhibitor or intolerance to SGLT2-inhibitors
- Life expectancy < 12 months
- Symptomatic hypotension or persistent SBP < 100 mmHg
- Contraindications to CMRI
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| SGLT2 inhibitor10 mg orally once daily in addition to standard medical treatment. | Drug | Intervention group |
| PlaceboPlacebo tablets similar to active treatment. | Drug | Control group |
Primary outcome
Composite endpoint of changes in LV mass, systolic function, eGFR, and serum Nt-proBNP
Time frame: Baseline assesment to 12-months follow-up post-TAVR
Changes from baseline to 12 months of follow-up in at least 2 out of 4 well-known parameters is required to reach the primary endpoint: * LVMi (grams) reduction of 10 % point (by CMRI) * LV GLS (percent) absolute increase of 2.0 % point (by TTE) * A decrease in serum Nt-proBNP (ng/L) of more than 25% * Relative increase of 10% in eGFR (ml/min/1.73m^2) If 2 or more of the 4 outcome measures are reached at 12-months follow-up, the patient has fulfilled the primary end-point.
17 secondary outcomes
Difference in the change in eGFR
Time frame: baseline to 12-months
Difference in eGFR
Time frame: 12-months
The number of patients with a relative difference of 10 % of myocardial interstitial fibrosis evaluated by the biomarker extracellular volume (ECV) by late enhancement gadolinium by CMR
Time frame: Baseline to 12-months
The number of patients with a >10% decrease in cardiac fibrosis when assessed by histology and quantified by stereology (sub study)
Time frame: Baseline to 12-months
The number of patients with an increase in the respiratory control ratio (RCR) by ≥10% measured by High Resolution Respirometry (HRR) (sub study)
Time frame: Baseline to 12-months
Composite endpoint of worsening HF with hospitalization or urgent outpatient clinical visit due to HF, and all-cause mortality.
Time frame: 12-months post-TAVR
All-cause mortality
Time frame: Baseline to 12-months post-TAVR
Worsening HF with hospitalization or urgent outpatient clinical visit due to HF
Time frame: 12-months post-TAVR
Difference in the change in urinary albumin/creatinine ratio
Time frame: Baseline to 12-months
Difference in ACR at 12-months follow-up
Time frame: 12-months follow-up
24-hour ambulatory blood pressure changes
Time frame: baseline to 12 months
Change from baseline to 12-months follow-up in the Kansas City Cardiomyopathy questionnaire
Time frame: Baseline to 12-months
Change from baseline to 12-months follow-up in New York Heart Association-class (NYHA)
Time frame: baseline to 12-months.
LVMi reduction of 10 % point (by CMRI)
Time frame: baseline to 12-months.
LV GLS absolute increase of 2.0 % point (by TTE)
Time frame: Baseline to 12-months follow-up
A decrease in serum Nt-proBNP of more than 25% follow-up
Time frame: baseline to 12-months follow-up.
Relative increase of 10% in eGFR
Time frame: Baseline to 12-months follow-up
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Feb 2022.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Steen Hvitfeldt Poulsen principal investigator
Aarhus University Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2/3 study testing SGLT2 inhibitor in people with Aortic Stenosis and Left Ventricle Hypertrophied, run by University of Aarhus at 1 site in Denmark.
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 9 inclusion and 12 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: status not confirmed, as of the sponsor's last update on 15 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Denmark. 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 combined phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Anders Lehmann Dahl Pedersen, MD (0045 2785 2009, anlepe@rm.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Composite endpoint of changes in LV mass, systolic function, eGFR, and serum Nt-proBNP (time frame: Baseline assesment to 12-months follow-up post-TAVR). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 15 Feb 2022.