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Effects of Dapagliflozin on EChOcardiographic Measures of CarDiac StructurE and Function in Patients With CKD (DECODE-CKD)

Primary Purpose

Chronic Kidney Diseases

Status
Recruiting
Phase
Phase 2
Locations
Denmark
Study Type
Interventional
Intervention
Dapagliflozin 10 mg
Placebo
Sponsored by
Tor Biering-Sørensen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Kidney Diseases

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Signed informed consent
  • ≥ 18 years of age
  • Chronic Kidney Disease (CKD), defined as evidence of decreased eGFR (eGFR >20 and <60 mL/min/1.73 m2) at least 3 months before and at the time of screening
  • 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

  • Receiving cytotoxic therapy, immunosuppressive therapy or other immunotherapy for primary or secondary renal disease within 6 months prior to enrolment
  • 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
  • Hepatic impairment (aspartate transaminase or alanine transaminase >3 times the upper limit of normal [ULN] or total bilirubin >2 times the ULN at the time of enrolment)
  • Known blood-borne diseases, such as Hepatitis A, B, C, D, and E, and Human immunodeficiency virus (HIV) types 1 and 2, Ebola, Lassa fever virus.
  • Female patients who are pregnant, lactating, or are considering becoming pregnant during the study or for 6 months after study completion
  • Participation in another clinical study with an investigational product within the last month prior to enrolment
  • Inability to understand or comply with the investigational product, procedures, and/or follow-up or any conditions that may prevent the participant to complete the study

Sites / Locations

  • Gentofte HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Dapagliflozin 10 mg once daily

Placebo once daily

Arm Description

Outcomes

Primary Outcome Measures

Change in LV mass index assessed by echocardiography at 6 months

Secondary Outcome Measures

Change in LV dimensions assessed by echocardiography at 6 months
Change in LVEF assessed by echocardiography at 6 months
Change in E-wave assessed by echocardiography at 6 months
Change in A-wave assessed by echocardiography at 6 months
Change in E/e' assessed by echocardiography at 6 months
Change in E/A ratio assessed by echocardiography at 6 months
Change in LA volume assessed by echocardiography at 6 months
Change in GLS assessed by echocardiography at 6 months
Change in LA strain assessed by echocardiography at 6 months
Change in RV strain assessed by echocardiography at 6 months
Change in high sensitivity troponin I (hs-TNI) at 6 months
Change in Soluble suppression of tumorigenicity 2 (sST2) at 6 months
Change in N-terminal pro B-type natriuretic peptide (NT-pro-BNP) at 6 months
Change in necrosis factor α (TNF-α) at 6 months
Change in copeptin at 6 months
Change in high sensitivity C-reactive protein (hs-CRP) at 6 months
Change in estimated glomerular filtration rate (eGFR) 6 months
Change in serum potassium at 6 months
Change in serum neutrophil gelatinase-associated lipocalin (sNGAL) at 6 months
Change in urinary neutrophil gelatinase-associated lipocalin (uNGAL) at 6 months
Change in urinary kidney injury molecule-1 (KIM-1) at 6 months
Change in insulin growth factor-binding protein-7 (IGFBP7) at 6 months
Change in serum cystatin C at 6 months
Change in uric acid at 6 months
Change in urinary albumin-to-creatinine ratio (UACR) at 6 months
Change in erythropoietin (EPO) at 6 months
Change in estimated plasma volume at 6 months
Change in hemoglobin at 6 months
Change in hemotocrit at 6 months
Change in ferritin at 6 months
Change in transferrin at 6 months
Change in iron at 6 months
Change in calcium at 6 months
Change in phosphate at 6 months
Change in magnesium at 6 months
Change in PTH at 6 months
Change in fibroblast growth factor 23 (FGF-23) at 6 months
Change in calcification propensity (T50) at 6 months
Change in fetuin-A (fetA) at 6 months
Change in bicarbonate at 6 months
Change in klotho at 6 months
Change in urine sodium at 6 months
Change in urine glucose at 6 months
Change in hemoglobin A1C at 6 months
Changein central blood pressure assessed by pulse wave analysis at 6 months
augmentation index assessed by pulse wave analysis at 6 months

Full Information

First Posted
April 28, 2022
Last Updated
December 21, 2022
Sponsor
Tor Biering-Sørensen
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1. Study Identification

Unique Protocol Identification Number
NCT05359263
Brief Title
Effects of Dapagliflozin on EChOcardiographic Measures of CarDiac StructurE and Function in Patients With CKD
Acronym
DECODE-CKD
Official Title
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
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
June 8, 2022 (Actual)
Primary Completion Date
April 15, 2025 (Anticipated)
Study Completion Date
April 15, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Tor Biering-Sørensen

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
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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Kidney Diseases

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
222 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dapagliflozin 10 mg once daily
Arm Type
Experimental
Arm Title
Placebo once daily
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Dapagliflozin 10 mg
Intervention Description
The intervention arm consists of dapagliflozin 10 mg orally once daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
The comparator arm consists of placebo orally once daily
Primary Outcome Measure Information:
Title
Change in LV mass index assessed by echocardiography at 6 months
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Change in LV dimensions assessed by echocardiography at 6 months
Time Frame
6 months
Title
Change in LVEF assessed by echocardiography at 6 months
Time Frame
6 months
Title
Change in E-wave assessed by echocardiography at 6 months
Time Frame
6 months
Title
Change in A-wave assessed by echocardiography at 6 months
Time Frame
6 months
Title
Change in E/e' assessed by echocardiography at 6 months
Time Frame
6 months
Title
Change in E/A ratio assessed by echocardiography at 6 months
Time Frame
6 months
Title
Change in LA volume assessed by echocardiography at 6 months
Time Frame
6 months
Title
Change in GLS assessed by echocardiography at 6 months
Time Frame
6 months
Title
Change in LA strain assessed by echocardiography at 6 months
Time Frame
6 months
Title
Change in RV strain assessed by echocardiography at 6 months
Time Frame
6 months
Title
Change in high sensitivity troponin I (hs-TNI) at 6 months
Time Frame
6 months
Title
Change in Soluble suppression of tumorigenicity 2 (sST2) at 6 months
Time Frame
6 months
Title
Change in N-terminal pro B-type natriuretic peptide (NT-pro-BNP) at 6 months
Time Frame
6 months
Title
Change in necrosis factor α (TNF-α) at 6 months
Time Frame
6 months
Title
Change in copeptin at 6 months
Time Frame
6 months
Title
Change in high sensitivity C-reactive protein (hs-CRP) at 6 months
Time Frame
6 months
Title
Change in estimated glomerular filtration rate (eGFR) 6 months
Time Frame
6 months
Title
Change in serum potassium at 6 months
Time Frame
6 months
Title
Change in serum neutrophil gelatinase-associated lipocalin (sNGAL) at 6 months
Time Frame
6 months
Title
Change in urinary neutrophil gelatinase-associated lipocalin (uNGAL) at 6 months
Time Frame
6 months
Title
Change in urinary kidney injury molecule-1 (KIM-1) at 6 months
Time Frame
6 months
Title
Change in insulin growth factor-binding protein-7 (IGFBP7) at 6 months
Time Frame
6 months
Title
Change in serum cystatin C at 6 months
Time Frame
6 months
Title
Change in uric acid at 6 months
Time Frame
6 months
Title
Change in urinary albumin-to-creatinine ratio (UACR) at 6 months
Time Frame
6 months
Title
Change in erythropoietin (EPO) at 6 months
Time Frame
6 months
Title
Change in estimated plasma volume at 6 months
Time Frame
6 months
Title
Change in hemoglobin at 6 months
Time Frame
6 months
Title
Change in hemotocrit at 6 months
Time Frame
6 months
Title
Change in ferritin at 6 months
Time Frame
6 months
Title
Change in transferrin at 6 months
Time Frame
6 months
Title
Change in iron at 6 months
Time Frame
6 months
Title
Change in calcium at 6 months
Time Frame
6 months
Title
Change in phosphate at 6 months
Time Frame
6 months
Title
Change in magnesium at 6 months
Time Frame
6 months
Title
Change in PTH at 6 months
Time Frame
6 months
Title
Change in fibroblast growth factor 23 (FGF-23) at 6 months
Time Frame
6 months
Title
Change in calcification propensity (T50) at 6 months
Time Frame
6 months
Title
Change in fetuin-A (fetA) at 6 months
Time Frame
6 months
Title
Change in bicarbonate at 6 months
Time Frame
6 months
Title
Change in klotho at 6 months
Time Frame
6 months
Title
Change in urine sodium at 6 months
Time Frame
6 months
Title
Change in urine glucose at 6 months
Time Frame
6 months
Title
Change in hemoglobin A1C at 6 months
Time Frame
6 months
Title
Changein central blood pressure assessed by pulse wave analysis at 6 months
Time Frame
6 months
Title
augmentation index assessed by pulse wave analysis at 6 months
Time Frame
6 months
Other Pre-specified Outcome Measures:
Title
Change in MoCA score at 6 months
Description
Cognitive impairment will be assessed using the change of the Montreal Cognitive Assessment (MoCA)
Time Frame
6 months
Title
Change in Quality of Life at 6 months
Description
Health-related quality of life will be quantified using the validated self-administered questionnaire the Kidney Disease Quality of Life questionnaire (KDQOL-36)
Time Frame
6 months
Title
Change in HADS score at 6 months
Description
Depressive symptoms will be assessed using The Hospital Depression and Anxiety Scale.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
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/min/1.73 m2) at least 3 months before and at the time of screening 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 Receiving cytotoxic therapy, immunosuppressive therapy or other immunotherapy for primary or secondary renal disease within 6 months prior to enrolment 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 Hepatic impairment (aspartate transaminase or alanine transaminase >3 times the upper limit of normal [ULN] or total bilirubin >2 times the ULN at the time of enrolment) Known blood-borne diseases, such as Hepatitis A, B, C, D, and E, and Human immunodeficiency virus (HIV) types 1 and 2, Ebola, Lassa fever virus. Female patients who are pregnant, lactating, or are considering becoming pregnant during the study or for 6 months after study completion Participation in another clinical study with an investigational product within the last month prior to enrolment Inability to understand or comply with the investigational product, procedures, and/or follow-up or any conditions that may prevent the participant to complete the study
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Katja Vu Bartholdy, MD
Phone
+4531360232
Email
katja.vu.bartholdy@regionh.dk
First Name & Middle Initial & Last Name or Official Title & Degree
Niklas Dyrby Johansen
Phone
+4520204794
Email
niklas.dyrby.johansen@regionh.dk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tor Biering-Sørensen
Organizational Affiliation
Research Director
Official's Role
Study Chair
Facility Information:
Facility Name
Gentofte Hospital
City
Copenhagen
ZIP/Postal Code
2900
Country
Denmark
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Katja Vu Bartholdy, MD

12. IPD Sharing Statement

Plan to Share IPD
Yes

Learn more about this trial

Effects of Dapagliflozin on EChOcardiographic Measures of CarDiac StructurE and Function in Patients With CKD

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