Impact of a Short-term Treatment With Canagliflozin (Canacardia-HF) (Canacardia)
Primary Purpose
Type2 Diabetes, Heart Failure
Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Canagliflozin 100mg
Placebo oral capsule
PET imaging
Sponsored by
About this trial
This is an interventional basic science trial for Type2 Diabetes
Eligibility Criteria
Inclusion Criteria:
- HbA1c 7.5 -10.5%;
- LVEF < 40%;
- NYHA class 2 or 3;
- NT pro-BNP level > 600 pg/mL;
- Being on a stable-dose metformin therapy max 2500 mg/day or other hypoglycemic therapy and RAAS-blocking agents for at least 8 weeks;
- Being on optimal and stable-doses of heart failure medication including diuretics for at least 4 weeks;
Exclusion Criteria:
- age <18 yo;
- NYHA class 4;
- Treatment with a fibrate or thiazolidinedione;
- Unstable or advanced renal failure;
- Unstable or new medical or surgical condition within the past 3 months;
- Heart failure caused by active inflammatory condition such as sarcoidosis or any form of myocarditis;
- History of diabetic ketoacidosis;
- Not on a stable regimen for at least 8 weeks before the screening visit;
- Female of child-bearing potential who is pregnant, breast feeding or intends to become pregnant or pre-menopausal female with a positive serum pregnancy test at the time of enrollment;
- Patients post bariatric surgery, or on weight loss medication;
- Contraindications to metformin, including allergy or intolerance;
- Hospitalization for heart failure within the 60 days prior to enrollment;
- Admission for an acute coronary syndrome, percutaneous coronary intervention, or cardiac surgery within the 60 days prior to enrollment;
- Planned cardiovascular revascularization (percutaneous intervention or surgical) or major cardiac surgery (coronary artery bypass grafting, valve replacement, ventricular assist device, cardiac transplantation, or any other surgery requiring thoracotomy) within the 90 days after enrollment;
- Patients who are volume depleted based upon physical examination at the time of enrollment;
- Chronic disabling illness;
- History of substance abuse.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Experimental
Arm Label
Treatment 1
Treatment 2
Arm Description
placebo oral capsule will be administered once daily, for 2 weeks
Canagliflozine 100mg once daily, for 2 weeks
Outcomes
Primary Outcome Measures
Change to be observed with canagliflozin on myocardial dietary fatty acid uptake
will be assessed using oral administration of 18-fluoro-thiaheptadecanoic acid ([18F]-FTHA) with sequential dynamic.
PET/CT scanning.
Change to be observed with canagliflozin on whole-body partitioning.
will be assessed using oral administration of 18-fluoro-thiaheptadecanoic acid ([18F]-FTHA, with static PET/CT scanning
Secondary Outcome Measures
myocardial and liver NEFA uptake
using PET with [11C]-palmitate
NEFA oxidative rate
using PET with [11C]-acetate
plasma NEFA turnover
using i.v. infusion of [U-13C]-palmitate
Full Information
NCT ID
NCT03298009
First Posted
September 26, 2017
Last Updated
April 15, 2019
Sponsor
Université de Sherbrooke
Collaborators
Janssen Inc.
1. Study Identification
Unique Protocol Identification Number
NCT03298009
Brief Title
Impact of a Short-term Treatment With Canagliflozin (Canacardia-HF)
Acronym
Canacardia
Official Title
Subclinical Inflammation, Myocardial Function and Fatty Acid Metabolism in Patients With Type 2 Diabetes and Heart Failure: Impact of a Short-term Treatment With Canagliflozin - a Pilot Study
Study Type
Interventional
2. Study Status
Record Verification Date
April 2019
Overall Recruitment Status
Withdrawn
Why Stopped
end of contract negociations
Study Start Date
November 1, 2017 (Anticipated)
Primary Completion Date
November 1, 2018 (Anticipated)
Study Completion Date
January 1, 2019 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Université de Sherbrooke
Collaborators
Janssen Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
It is a mechanistic proof-of-concept study to demonstrate how SGLT-2 inhibitors (Canagliflozin) may have a beneficial role on cardiac energetic efficiency.
Patients with type 2 diabetes and with HF diagnosed for at least 3 months will be selected. The participants will be randomized to a double-blind, crossover 2-week placebo vs. Cana 100 mg once daily, an interventional trial with a one-month washout period in between.
At the term of the two-week placebo and canagliflozin treatment periods (visits 2 and 4), each participant will undergo an identical postprandial metabolic study with positron emission tomography (PET) and stable isotopic tracer methods.
Detailed Description
Non-invasive Positron Emission Tomography (PET) imaging method allows to measure myocardial uptake and organ-specific partitioning of dietary fatty acids (DFA). It allows to study kidney, liver, skeletal muscles and adipose tissues DFA utilization, whole body fatty acid turnover and oxidation rates, myocardial oxidative metabolism and left ventricular (LV) function that are other likely targets of SGLT-2 inhibitors. Thus, the PET is ideal to verify the very interesting hypothesis that, increase in liver fatty acid utilization and/or adipose tissue dietary fatty acid uptake, may lead to reduced cardiac utilization of fatty acids and improved cardiac energetic efficiency.
.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type2 Diabetes, Heart Failure
7. Study Design
Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Placebo-controlled, double-blind, randomized crossover 2-week intervention study.
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Treatment 1
Arm Type
Placebo Comparator
Arm Description
placebo oral capsule will be administered once daily, for 2 weeks
Arm Title
Treatment 2
Arm Type
Experimental
Arm Description
Canagliflozine 100mg once daily, for 2 weeks
Intervention Type
Drug
Intervention Name(s)
Canagliflozin 100mg
Other Intervention Name(s)
Invokana
Intervention Description
2-week intervention
Intervention Type
Drug
Intervention Name(s)
Placebo oral capsule
Intervention Description
2-week intervention
Intervention Type
Radiation
Intervention Name(s)
PET imaging
Intervention Description
1 day postprandial metabolic protocol at the end of treatment: CT scan followed by dynamic and pancorporel imaging
Primary Outcome Measure Information:
Title
Change to be observed with canagliflozin on myocardial dietary fatty acid uptake
Description
will be assessed using oral administration of 18-fluoro-thiaheptadecanoic acid ([18F]-FTHA) with sequential dynamic.
PET/CT scanning.
Time Frame
3 months
Title
Change to be observed with canagliflozin on whole-body partitioning.
Description
will be assessed using oral administration of 18-fluoro-thiaheptadecanoic acid ([18F]-FTHA, with static PET/CT scanning
Time Frame
3 months
Secondary Outcome Measure Information:
Title
myocardial and liver NEFA uptake
Description
using PET with [11C]-palmitate
Time Frame
3 months
Title
NEFA oxidative rate
Description
using PET with [11C]-acetate
Time Frame
3 months
Title
plasma NEFA turnover
Description
using i.v. infusion of [U-13C]-palmitate
Time Frame
1 year
Other Pre-specified Outcome Measures:
Title
Insulin sensitivity
Description
will be determined using the HOMA-IR (based on fasting insulin and glucose levels)
Time Frame
1 year
Title
Insulin secretion rate
Description
will be assessed using deconvolution of plasma C-peptide with standard Cpeptide kinetic parameters
Time Frame
1 year
Title
β-cell function
Description
will be assessed by calculation of the disposition index (DI) that is insulin secretion in response to the ambient insulin
Time Frame
1 year
Title
hormonal response
Description
will be determined using a multiplex assay system
Time Frame
1 year
Title
Biomarkers
Description
Assays will be performed using the BIOPLEX
Time Frame
1 year
Title
body composition
Description
DXA
Time Frame
3 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
HbA1c 7.5 -10.5%;
LVEF < 40%;
NYHA class 2 or 3;
NT pro-BNP level > 600 pg/mL;
Being on a stable-dose metformin therapy max 2500 mg/day or other hypoglycemic therapy and RAAS-blocking agents for at least 8 weeks;
Being on optimal and stable-doses of heart failure medication including diuretics for at least 4 weeks;
Exclusion Criteria:
age <18 yo;
NYHA class 4;
Treatment with a fibrate or thiazolidinedione;
Unstable or advanced renal failure;
Unstable or new medical or surgical condition within the past 3 months;
Heart failure caused by active inflammatory condition such as sarcoidosis or any form of myocarditis;
History of diabetic ketoacidosis;
Not on a stable regimen for at least 8 weeks before the screening visit;
Female of child-bearing potential who is pregnant, breast feeding or intends to become pregnant or pre-menopausal female with a positive serum pregnancy test at the time of enrollment;
Patients post bariatric surgery, or on weight loss medication;
Contraindications to metformin, including allergy or intolerance;
Hospitalization for heart failure within the 60 days prior to enrollment;
Admission for an acute coronary syndrome, percutaneous coronary intervention, or cardiac surgery within the 60 days prior to enrollment;
Planned cardiovascular revascularization (percutaneous intervention or surgical) or major cardiac surgery (coronary artery bypass grafting, valve replacement, ventricular assist device, cardiac transplantation, or any other surgery requiring thoracotomy) within the 90 days after enrollment;
Patients who are volume depleted based upon physical examination at the time of enrollment;
Chronic disabling illness;
History of substance abuse.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
André C. Carpentier
Organizational Affiliation
Université de Sherbrooke
Official's Role
Principal Investigator
12. IPD Sharing Statement
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Impact of a Short-term Treatment With Canagliflozin (Canacardia-HF)
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