UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000045229
Receipt number R000051667
Scientific Title Effect of Long-Acting vs. Short-Acting Loop Diuretics and Neurohormonal Agents on Patients' Quality-of-Life Among Patients with Heart Failure
Date of disclosure of the study information 2021/08/24
Last modified on 2024/02/24 10:55:31

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Basic information

Public title

Effect of Long-Acting vs. Short-Acting Loop Diuretics and Neurohormonal Agents on Patients' Quality-of-Life Among Patients with Heart Failure

Acronym

LAQUA-HF Trial

Scientific Title

Effect of Long-Acting vs. Short-Acting Loop Diuretics and Neurohormonal Agents on Patients' Quality-of-Life Among Patients with Heart Failure

Scientific Title:Acronym

LAQUA-HF Trial

Region

Japan


Condition

Condition

Heart failure

Classification by specialty

Medicine in general Cardiology

Classification by malignancy

Others

Genomic information

YES


Objectives

Narrative objectives1

LAQUA-HF is a pragmatic, randomized, with a 2x2 factorial design to compare 1) torsemide versus furosemide and 2) angiotensin receptor II blocker/neprilysin inhibitor (sacubitril/valsartan) versus sodium-glucose cotransporter 2 inhibitors (dapagliflozin 10 mg); the primary objective is to compare the patients' reported outcomes over 6 months after randomization in patients with heart failure with reduced ejection fraction.

Basic objectives2

Efficacy

Basic objectives -Others


Trial characteristics_1

Confirmatory

Trial characteristics_2

Pragmatic

Developmental phase

Not applicable


Assessment

Primary outcomes

The mean changes in Kansas City Cardiomyopathy Questionnaire overall summary (KCCQ-OS) score from the start of the intervention to 6 months.

Key secondary outcomes

- The hierarchical composite endpoint consisting of the time to all-cause death, total number of worsening HFEs, the time to first HFEs within 6 months, and non-improvement in KCCQ-OSS of less than 5 points from baseline to 6 months, assessed by the win ratio.
- The composite of all-cause death and the non-improvement in KCCQ-OS score (less than 5 points) from the start of the intervention to 6 months.
The mean changes in the NT-proBNP levels from baseline to 6 months.
- The composite of all-cause death and non-improvement in the NT-proBNP levels (less than 20%) from the start of the intervention to 6 months.
- The composite of all-cause death, heart failure hospitalization, non-improvement in KCCQ-OS score (less than 5 points), and non-improvement in the NT-proBNP levels (less than 20%) from the start of the intervention to 6 months.
- The incidence of all-cause death, cardiovascular death, heart failure hospitalization, unscheduled office visits for worsening heart failure with an increasing dose of diuretics or intravenous infusion from the start of the intervention to 6 months.
- The mean changes in the KCCQ-clinical summary (KCCQ-CS) score and non-improvement in the KCCQ-CS score (less than 5 points) from the start of the intervention to 6 months.
- The mean changes in the KCCQ- total symptom score (KCCQ-TS) and non-improvement in the KCCQ-TS score (less than 5 points) from the start of the intervention to 6 months.
- The mean changes in left ventricular ejection fraction (LVEF) from the start of the intervention to 6 months.
- The mean changes in estimated glomerular filtration ratio (eGFR) from the start of the intervention to 6 months.
- The incidence of all-cause death, cardiovascular death, and heart failure hospitalization from the start of the intervention to 2 years.


Base

Study type

Interventional


Study design

Basic design

Factorial

Randomization

Randomized

Randomization unit

Individual

Blinding

Open -but assessor(s) are blinded

Control

Active

Stratification

YES

Dynamic allocation

YES

Institution consideration

Institution is considered as adjustment factor in dynamic allocation.

Blocking

NO

Concealment

Central registration


Intervention

No. of arms

4

Purpose of intervention

Treatment

Type of intervention

Medicine

Interventions/Control_1

Torsemide (oral dosing of torsemide compared to furosemide will be 1mg: 2.5-5mg) with sacubitril/valsartan 50 mg b.i.d. as started dose, after every 2-4 weeks dose will be up titrated to the goal of 200 mg b.i.d
Other heart failure medications (except for an ACE inhibitor or ARB) will be continued during the trial.

Interventions/Control_2

Furosemide with sacubitril/valsartan 50 mg b.i.d. as started dose, after every 2-4 weeks dose will be up titrated to the goal of 200 mg b.i.d.
Other heart failure medications (except for an ACE inhibitor or ARB) will be continued during the trial.

Interventions/Control_3

Torsemide (oral dosing of torsemide compared to furosemide will be 1mg: 2.5-5.0mg) with dapagliflozin 10mg once a day.
Other heart failure medications (except for a sacubitril/valsartan) will be continued during the trial.

Interventions/Control_4

Furosemide with dapagliflozin 10mg once a day.
Other heart failure medications (except for a sacubitril/valsartan) will be continued during the trial.

Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

20 years-old <=

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

1) Patients with chronic heart failure with/without hospitalization within 1 year before enrollment
A. Patients hospitalized with worsening of chronic heart failure, or new diagnosis of heart failure within 1 year before enrollment AND has an elevated natriuretic peptide level (either NT-proBNP greater than or equal to 300 pg/mL or BNP greater than or equal to 100 pg/mL) with the most recent value used to determine eligibility. (In patients with atrial fibrillation, the level of NT-proBNP will be greater than or equal to 450 pg/mL or BNP greater than or equal to 150 pg/mL)
B. Patients with chronic heart failure without hospitalization within 1 year before enrollment AND have an elevated natriuretic peptide level (either NT-proBNP greater than or equal to 600 pg/mL or BNP greater than or equal to 150 pg/mL) with the most recent value used to determine eligibility. (In patients with atrial fibrillation, the level of NT-proBNP will be greater than or equal to 900 pg/mL or BNP greater than or equal to 225 pg/mL)
2) Patients with heart failure (NYHA functional class II, III, or IV) receiving oral loop diuretic.
3) Patients whose left ventricular ejection fraction is less than or equal to 50% within 1 year before enrollment.
4) Above 20 years of age
5) Able to consent for the trial.

Key exclusion criteria

1) Symptomatic hypotension and/or a systolic blood pressure < 100 mmHg at screening
2) Serum potassium greater than or equal to5.4 mEq/L at screening
3) eGFR < 30 ml/min/1.73m or end-stage renal disease requiring renal replacement therapy at the time of screening
4) Pregnant or nursing women, or history of hypersensitivity or allergy to any of the study drugs, drugs of similar chemical classes, as well as known or suspected contraindications to the study drugs.
5) Inability or unwillingness to comply with the study requirements
6) Patients who are unable to obtain written consent or require a substitute.

Target sample size

240


Research contact person

Name of lead principal investigator

1st name Shun
Middle name
Last name Kohsaka

Organization

Keio University School of Medicine

Division name

Department of Cardiology

Zip code

160-8582

Address

35 Shinanomachi, Shinjuku-ku, Tokyo

TEL

03-5843-6702

Email

sk@keio.jp


Public contact

Name of contact person

1st name Nobuhiro
Middle name
Last name Ikemura

Organization

Keio University School of Medicine

Division name

Department of Cardiology

Zip code

160-8582

Address

35 Shinanomachi, Shinjuku-ku, Tokyo

TEL

03-5843-6702

Homepage URL


Email

ikemu0129@keio.jp


Sponsor or person

Institute

Keio University School of Medicine, Department of Cardiology

Institute

Department

Personal name



Funding Source

Organization

Japan Society for the Promotion of Science

Organization

Division

Category of Funding Organization

Japanese Governmental office

Nationality of Funding Organization

Japan


Other related organizations

Co-sponsor

None

Name of secondary funder(s)



IRB Contact (For public release)

Organization

Keio University, School of medicine, Independent Ethics Committee

Address

35 Shinanomachi, Shinjuku-ku, Tokyo

Tel

03-5363-3503

Email

med-rinri-jimu@adst.keio.ac.jp


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions

慶應義塾大学病院(東京都)
榊原記念病院(東京都)
防衛医科大学校病院(埼玉県)
東京都済生会中央病院(東京都)
済生会宇都宮病院(栃木県)
埼玉医科大学国際医療センター(埼玉県)
杏林大学医学部付属病院(東京都)
東京慈恵会医科大学附属病院(東京都)
独立行政法人 国立病院機構 埼玉病院(埼玉県)
独立行政法人 国立病院機構 東京医療センター(東京都)
浜松医科大学医学部附属病院(静岡県)
足利赤十字病院(栃木県)
川崎市立川崎病院(神奈川県)
国際医療福祉大学成田病院(千葉県)


Other administrative information

Date of disclosure of the study information

2021 Year 08 Month 24 Day


Related information

URL releasing protocol


Publication of results

Unpublished


Result

URL related to results and publications


Number of participants that the trial has enrolled

240

Results


Results date posted


Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics


Participant flow


Adverse events


Outcome measures


Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

No longer recruiting

Date of protocol fixation

2021 Year 07 Month 30 Day

Date of IRB

2021 Year 07 Month 30 Day

Anticipated trial start date

2022 Year 01 Month 01 Day

Last follow-up date

2024 Year 02 Month 05 Day

Date of closure to data entry

2024 Year 03 Month 13 Day

Date trial data considered complete

2024 Year 03 Month 31 Day

Date analysis concluded

2024 Year 04 Month 30 Day


Other

Other related information



Management information

Registered date

2021 Year 08 Month 23 Day

Last modified on

2024 Year 02 Month 24 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000051667


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name