Heart Failure Clinical Trial
— CONFIRMATIONOfficial title:
Combined Efficacy and Safety of an Early, Intensive, Management Strategy With Finerenone and SGLT2 Inhibitor in Patients Hospitalized With Heart Failure (CONFIRMATION-HF)
Combination therapy with finerenone with empagliflozin will be compared to usual care to determine the efficacy and safety of treatment in patients hospitalized with heart failure.
Status | Not yet recruiting |
Enrollment | 1500 |
Est. completion date | August 2025 |
Est. primary completion date | August 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Provide electronic or written informed consent, either personally or through a legally authorized representative - Age =18 years or legal age of majority - Current hospitalization or recently discharged with the primary diagnosis of heart failure - Heart failure signs and symptoms at the time of hospital admission - Elevated N-terminal pro B-type natriuretic peptide (NTproBNP) =1000 pg/mL or B-type natriuretic peptide (BNP) =250 pg/mL according to the local lab for patients in sinus rhythm; or elevated NTproBNP =2000 pg/mL or BNP =500 pg/mL for patients with atrial fibrillation (AF), measured during the current hospitalization or in the 72 hours prior to hospital admission - Fulfillment of protocol defined stabilization criteria (if randomized during hospitalization) - Treatment during the index hospitalization with at least 1 intravenous dose of a loop diuretic (e.g., furosemide, torsemide, bumetanide). - Negative pregnancy test and agreement to use adequate contraception during trial (female participants only) Exclusion Criteria: - Diagnosis of type 1 diabetes or prior history of diabetic ketoacidosis - Documented prior history of severe hyperkalemia in the setting of MRA use - Treatment with non-steroidal mineralocorticoid receptor antagonist (MRA) or SGLT2i - Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73m² and/or serum/plasma potassium >5.0 mmol/L - Type 1 acute myocardial infarction, coronary revascularization, valve replacement/repair, or implantation of a cardiac resynchronization therapy device within 30 days - Prior or planned heart transplant - Hemodynamically significant uncorrected primary cardiac valvular disease as primary cause of heart failure - Cardiomyopathy due to acute inflammatory heart disease, infiltrative diseases, accumulation diseases, muscular dystrophies, cardiomyopathy with reversible causes, known hypertrophic obstructive cardiomyopathy, complex congenital heart disease, or pericardial constriction - Probable alternative cause of participant's heart failure symptoms - Concomitant systemic therapy with potent cytochrome P450 isoenzyme 3A4 (CYP3A4) inhibitors or moderate CYP3A4 inducers, or potent CYP3A4 inducers - Any other condition or therapy which would make the patient unsuitable for this study |
Country | Name | City | State |
---|---|---|---|
n/a |
Lead Sponsor | Collaborator |
---|---|
Colorado Prevention Center | Bayer, Saint Luke's Hospital of Kansas City |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Clinical benefit | Hierarchical composite of the following assessed by the win-ratio: Time to death from any cause Number of HF events Time to first HF event Difference of 5 points or greater on the Kansas City Cardiomyopathy Questionnaire - Total Symptom Score (KCCQ-TSS) |
6 months | |
Primary | Number of serious adverse events (AEs). | - Serious AEs (excluding efficacy endpoints). | 6 months | |
Primary | Number of adverse events leading to discontinuation of study drug. | - AEs leading to discontinuation of finerenone or empagliflozin. | 6 months | |
Secondary | Number of deaths from any cause and total HF events. | - All-cause mortality and total HF events (first and recurrent). | 6 months | |
Secondary | Change from baseline in the Total Symptom Score of the Kansas City Cardiomyopathy Questionnaire (KCCQ-TSS) at Month 6. | 6 months | ||
Secondary | Number of HF events at Day 90. | - Total (first and recurrent) HF events. | 90 days |
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