Heart Failure Clinical Trial
— SUBCUT-HF IIOfficial title:
Use of a Novel SUBCUTaneous Preparation of Furosemide to Facilitate Early Supported Discharge of Patients With Heart Failure: a Multicentre, Phase II, Randomised, Parallel Group, Active Comparator Controlled Trial
To investigate whether an early supported discharge strategy for patients admitted to hospital because of HF, using a pH neutral subcutaneous (SC) furosemide formulation (SQINFurosemide) at home (delivered by non-CE marked SQINInfusor), compared to a usual care strategy with intravenous (IV) furosemide in hospital, results in an increased number of days spent alive and out of hospital (DAOH) at 30 days.
Status | Recruiting |
Enrollment | 550 |
Est. completion date | August 30, 2024 |
Est. primary completion date | May 28, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Written informed consent - Male or female =18 years of age - Meet European Society of Cardiology (ESC) criteria for diagnosis of HF1 o Elevated natriuretic peptide (BNP> 100 pg/mL or NTproBNP >300 pg/mL) o Signs and symptoms of HF o Echocardiographic structural or functional abnormality according to ESC guidelines (Appendix B) - Have received IV diuretic for treatment of HF within preceding 24 hours - Be less than 96 hours after admission to hospital - Requiring IV diuretics for a minimum of 24 hours after screening - Have an echocardiogram or other assessment of cardiac structure and function within preceding 12 months or at screening - Have demonstrated an adequate diuresis with IV diuretic in the preceding 24 hours (defined as any weight loss or > 500 mLs negative fluid balance) - Have a home environment that allows the patient to be able to mobilise within their residence and be able to pass urine into their toilet (unless catheterised) - Able to operate (or has a caregiver who can operate) SQIN-Infusor (as assessed by training on a dummy device at screening) Exclusion Criteria: - Unable to consent due to significant cognitive impairment or lack of capacity - Unable to operate SQIN-Infusor (or no caregiver who is able to operate the device) - Geographical reasons preventing follow-up visits - Pregnancy or breast-feeding - Requiring treatment with IV furosemide >200 mg furosemide per day in the opinion of the treating physician - Left sided valve disease with planned surgery or percutaneous intervention• Type 1 myocardial infarction during index hospitalisation (participants with type 2 myocardial infarction can be included)2 - Renal impairment, defined as estimated glomerular filtration rate (eGFR) < 20 mL/min/1.73 m 2 at screening - Reasons (other than HF) which may prevent discharge from hospital, such as social circumstances or other significant medical condition (at investigator discretion) - Women of childbearing potential - Patient on active cardiac transplant waiting list - Patient requiring on-going inotropic, vasopressor or intraaortic balloon pump support - Potassium <3.0 mmol/L - Potassium >6.0 mmol/L - Sodium <125 mmol/L - Any surgical or medical condition which, in the opinion of the investigator, may pose an undue risk to the subject, interfere with participation in the study or which may affect the integrity of the data |
Country | Name | City | State |
---|---|---|---|
United Kingdom | Glasgow Royal Infirmary | Glasgow | Scotland |
United Kingdom | Queen Elizabeth University Hospital | Glasgow | Strathclyde |
Lead Sponsor | Collaborator |
---|---|
NHS Greater Glasgow and Clyde | University of Glasgow |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Days Alive Out of Hospital | Days spent alive and out of hospital (DAOH), from randomisation to 30 days. | 30 days | |
Secondary | Length of index hospitalisation | Length of index hospitalisation | 30 days | |
Secondary | Change in quality of life | Change in quality of life at 60 days (assessed by Kansas City Cardiomyopathy Questionnaire [KCCQ-12]) [0-100] | 60 days | |
Secondary | Days Alive Out of Hospital | Days spent alive and out of hospital (DAOH), from randomisation to 60 days. | 60 days | |
Secondary | Total number of HF hospitalisations at 60 days | Total number of HF hospitalisations at 60 days | 60 days | |
Secondary | CV death or first HF hospitalisation at 60 days | CV death or first HF hospitalisation at 60 days | 60 days | |
Secondary | CV mortality at 60 days | CV mortality at 60 days | 60 days | |
Secondary | Safety as determined by treatment emergent adverse events (TEAEs) (including serious adverse events [SAEs]) and adverse drug events (ADEs) (including serious adverse drug events [SADEs]) | Safety as determined by treatment emergent adverse events (TEAEs) (including serious adverse events [SAEs]) and adverse drug events (ADEs) (including serious adverse drug events [SADEs]) | 60 days | |
Secondary | Any device failures (e.g., adhesive failure and drug delivery failure) | Any device failures (e.g., adhesive failure and drug delivery failure) | 60 days |
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