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This Study Tests Empagliflozin in Patients With Chronic Heart Failure With Reduced Ejection Fraction (HFrEF). The Study Looks at How Far Patients Can Walk in 6 Minutes and at Their Heart Failure Symptoms

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT03448419
Recruitment Status : Active, not recruiting
First Posted : February 28, 2018
Last Update Posted : October 2, 2019
Eli Lilly and Company
Information provided by (Responsible Party):
Boehringer Ingelheim

Brief Summary:
The primary objective of the study is to evaluate the effect of empagliflozin 10 mg versus placebo on exercise ability using the 6 minute walk test in patients with chronic HF with reduced ejection fraction (LVEF ≤ 40%) Secondary objectives are to assess Patient-Reported Outcome (PRO)

Condition or disease Intervention/treatment Phase
Heart Failure Drug: Empagliflozin Drug: Placebo Phase 3

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 300 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase III Randomised, Double-blind Trial to Evaluate the Effect of 12 Weeks Treatment of Once Daily EMPagliflozin 10 mg Compared With Placebo on ExeRcise Ability and Heart Failure Symptoms, In Patients With Chronic HeArt FaiLure With Reduced Ejection Fraction (HFrEF) (EMPERIAL-reduced)
Actual Study Start Date : March 20, 2018
Estimated Primary Completion Date : September 26, 2019
Estimated Study Completion Date : October 3, 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Failure

Arm Intervention/treatment
Experimental: Empagliflozin Drug: Empagliflozin
Film-coated tablet

Placebo Comparator: Placebo Drug: Placebo
Film-coated tablet

Primary Outcome Measures :
  1. The primary endpoint is the change from baseline to week 12 in exercise capacity as measured by the distance walked in 6 minutes in standardised conditions [ Time Frame: Up to week 0 and up to week 12 ]

Secondary Outcome Measures :
  1. Change from baseline to week 12 in Kansas City Cardiomyopathy Questionnaire (KCCQ) Total Symptom Score (TSS) [ Time Frame: Week 0 and Week 12 ]
  2. Change from baseline to week 12 in Chronic Heart Failure Questionnaire Self- Administered Standardized format (CHQ-SAS) dyspnea score [ Time Frame: Week 0 and Week 12 ]
  3. Change from baseline to week 6 in exercise capacity as measured by the distance walked in 6 minutes [ Time Frame: Week 0 and Week 6 ]
  4. Change from baseline in Clinical Congestion Score at week 12 [ Time Frame: Week 0 and Week 12 ]
  5. Change from baseline in Patient Global Impression of Severity (PGI-S) of Heart Failure Symptoms at week 12 [ Time Frame: Week 0 and Week 12 ]
  6. Change from baseline in Patient Global Impression of Dyspnea Severity at week 12 [ Time Frame: Week 0 and Week 12 ]
  7. Patient Global Impression of Change (PGI-C) in Heart Failure Symptoms at week 12 [ Time Frame: Week 12 ]
  8. Patient Global Impression of Change in Dyspnea at week 12 [ Time Frame: Week 12 ]
  9. Change from baseline in N-terminal pro-brain natriuretic peptide (NTproBNP) at week 12 [ Time Frame: Week 0 and Week 12 ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Of full age of consent (according to local legislation, usually ≥ 18 years) at screening.
  • Male or female patients. Women of childbearing potential (WOCBP)1 must be ready and able to use highly effective methods of birth control per ICH M3 (R2) that result in a low failure rate of less than 1% per year when used consistently and correctly. A list of contraception methods meeting these criteria is provided in the patient information.
  • Signed and dated written informed consent in accordance with ICHGCP and local legislation prior to admission to the trial
  • 6MWT distance ≤350 m at screening and at baseline.
  • Patients with chronic HF diagnosed for at least 3 months before Visit 1 and currently in NYHA class II-IV
  • Chronic HF with reduced EF defined as LVEF ≤ 40 % as per echocardiography at Visit 1 as per local reading (obtained under stable condition).
  • Elevated NT-proBNP > 450 pg/ml for patients without atrial fibrillation (AF) OR NTproBNP > 600 pg/ml for patients with AF as analysed at the Central laboratory at Visit 1
  • Patients must be clinically stable and on appropriate and stable dose of medical therapy for HF (such as ACEi, ARB, β-blocker, oral diuretics, MRA, ARNI, ivabradine), consistent with prevailing CV guidelines, stable for at least 4 weeks prior to Visit 1(screening) with the exception of diuretics which must have been stable for at least two weeks prior to Visit 1. The investigator must document the reason in case the patient is not on such medication or if not on target dose of any heart failure medication as per local guidelines.
  • Clinically stable at randomization with no signs of heart failure decompensation (as per investigator judgement).
  • Appropriate use of medical devices such as cardioverter defibrillator (ICD) or a cardiac resynchronization therapy (CRT) consistent with prevailing local or international CV guidelines, and if a device is required, it must have been implanted for at least 3 months prior to visit 1 for CRT and 1 month prior to visit 1 for ICD.

Exclusion Criteria:

  • Myocardial infarction (increase in cardiac enzymes in combination with symptoms of ischaemia or newly developed ischaemic ECG changes), coronary artery bypass graft surgery or other major cardiovascular surgery, stroke or TIA in past 90 days prior to Visit 1
  • Acute decompensated HF (exacerbation of chronic HF) requiring intravenous (i.v.) diuretics, i.v. inotropes or i.v. vasodilators, or left ventricular assist device within 4 weeks prior to Visit 1, and/or during screening period until Visit 2
  • Previous or current randomisation in another Empagliflozin Heart Failure trial (i.e. studies 1245.110, 1245.121, 1245-0167)
  • Type 1 Diabetes Mellitus (T1DM)
  • Impaired renal function, defined as eGFR < 20 mL/min/1.73 m2 (CKD-EPIcr) or requiring dialysis, as determined at Visit 1
  • Symptomatic hypotension or a SBP < 100 mmHg at Visit 1 or 2
  • Systolic blood pressure (SBP) ≥ 180 mmHg at Visit 1 or 2, or SBP >160mmHg at both Visit 1 and 2
  • Atrial fibrillation or atrial flutter with a resting heart rate >110 bpm documented by ECG at Visit 1 (Screening)
  • Unstable angina pectoris in past 30 days prior to Visit 1
  • Largest distance walked in 6 minutes (6MWTD) at baseline <100m.
  • Any presence of condition that precludes exercise testing such as:

    • claudication,
    • uncontrolled (according to investigator judgement) bradyarrhythmia or tachyarrhythmia,
    • significant musculoskeletal disease,
    • primary pulmonary hypertension,
    • severe obesity (body mass index ≥40.0 kg/m2),
    • orthopedic conditions that limit the ability to walk (such as arthritis in the leg, knee or hip injuries)
    • amputation with artificial limb without stable prosthesis function for the past 3 months
    • Any condition that, in the opinion of the investigator, would contraindicate the assessment of 6MWT
  • Patients in a structured (according to Investigator judgement) exercise training program in the 1 month prior to screening or planned to start one during the course of this trial.
  • Planned implantation of ICD or CRT during the course of the trial.
  • Treatment with i.v. iron therapy or erythropoietin within 3 months prior to screening
  • Treatment with i.v. iron therapy or erythropoietin within 3 months prior to screening
  • Further exclusion criteria applies

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03448419

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Sponsors and Collaborators
Boehringer Ingelheim
Eli Lilly and Company

Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Boehringer Ingelheim Identifier: NCT03448419     History of Changes
Other Study ID Numbers: 1245-0168
2017-004073-14 ( EudraCT Number )
First Posted: February 28, 2018    Key Record Dates
Last Update Posted: October 2, 2019
Last Verified: September 2019

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Heart Failure
Heart Diseases
Cardiovascular Diseases
Sodium-Glucose Transporter 2 Inhibitors
Molecular Mechanisms of Pharmacological Action
Hypoglycemic Agents
Physiological Effects of Drugs