Clinical trial NCT02920918: Treatment of Diabetes in Patients With Systolic Heart Failure
Official title: A Randomized Active-Control Double-Blinded Study to Evaluate the Treatment of Diabetes in Patients With Systolic Heart Failure
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Heart Failure, Systolic
Diabetes Mellitus, Type 2
Keywords: Systolic Heart Failure
Canagliflozin
Sitagliptin Phosphate
Type 2 Diabetes
SGLT2 inhibitor
DPPIV inhibitor
Lead sponsor: Virginia Commonwealth University
Sponsor class: OTHER
Collaborators: name: Janssen Scientific Affairs, LLC
First posted: 2016-09-30
Enrollment: 36
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Investigator Initiated Study to study the effects of Canagliflozin 100 milligrams (mg) vs Sitagliptin 100 mg on parameters of aerobic exercise capacity (peak oxygen consumption \[VO2\]) and ventilator efficiency (minute ventilation \[VE\]/carbon dioxide production \[VCO2\] slope) at cardiopulmonary exercise test (CPET) after 12 weeks of active treatment (primary endpoints). Blood pressure (BP), body water content, body composition, cardiac function, and diet will be also measured (secondary endpoints).

Detailed description: Investigator Initiated Study: Randomized, double-blinded, active-control clinical trial to determine the safety and efficacy of Canagliflozin and Sitagliptin in patients with type 2 diabetes and systolic heart failure (HF).

The investigators propose to study the effects of Canagliflozin 100 mg vs Sitagliptin 100 mg (both administered once daily for 12 weeks) on parameters of aerobic exercise capacity and ventilator efficiency by CPET after 12 weeks of active treatment. BP, body water content (Bioelectrical Impedance Analysis \[BIA\]), body composition (Dual-energy X-ray absorptiometry \[DEXA\]), cardiac function, diet and biomarkers will be also measured. Subjects with evidence of left ventricular hypertrophy will undergo cardiac magnetic resonance (CMR) imaging.

Eligibility criteria: Major Inclusion Criteria:

* Symptomatic stable heart failure (New York Heart Association (NYHA) functional classification II-III) with reduced left ventricular ejection fraction (LVEF) ≤40%
* Peak exercise limited by shortness of breath and associated with a respiratory exchange ratio (RER) \>1.00 (reflecting maximal aerobic effort);
* Poorly controlled Type 2 Diabetes Mellitus (T2DM)(HbA1c levels between 7.0% and 10.0% if on a treatment regimen including insulin, or between 6.5% and 10.0% if not on an insulin regimen);
* Eighteen years of age or older.

Major Exclusion Criteria:

* Type I diabetes;
* Open label treatment with Sodium-GLucose coTransporter (SGLT)-2 inhibitors (within the past 3 months);
* Current treatment with thiazolidinedione (within the past 3 months);
* Chronic Renal Disease defined as Glomerular Filtration Rate (GFR) \<50 ml•min-1/1.73m2 according to local laboratory
* Pregnancy or of child-bearing potential or lactating;
* Active or recent (within 2 weeks) genital/urinary infection;
* Concomitant conditions or treatment which would affect completion or interpretation of the study (i.e, physical inability to walk or run on a treadmill
* Inability to give informed consent.

Exclusion criteria specific to the cardiac magnetic resonance (CMR) substudy.

* Estimated GFR \<60 ml•min-1/1.73m2
* Implantable cardioverter defibrillator, pacemaker or other implantable metal device not compatible with CMR scanning;
* Severe claustrophobia, inability to lay flat for up to 60 minutes, or other contraindication to CMR scanning.

Primary outcomes:
measure: Change From Baseline Aerobic Exercise Capacity at 12 Weeks
timeFrame: baseline and 12 weeks
measure: Change From Baseline Ventilatory Efficiency at 12 Weeks
timeFrame: baseline and 12 weeks
Secondary outcomes:
Other outcomes:
Locations:
city: Richmond
country: United States
facility: Virginia Commonwealth University
state: Virginia
Study officials:
affiliation: Virginia Commonwealth University
name: Antonio Abbate, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References: