Saga University Hospital
Saga, 849-8501, Japan
NCT Number: NCT05164653
The aim of this study is to assess the treatment effect of sacubitril valsartan versus conventional therapy for heart failure (HF) in admitted patients due to exacerbation of HF on the N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP) concentrations.
This study is active but is not currently recruiting participants.
20 year and older
All sexes
Interventional
Phase 4
Saga, 849-8501, Japan
The high rate of rehospitalization and mortality of patients hospitalized for acute exacerbation of HF, especially at the early phase after discharge, has long been a serious clinical concern. However, few trials evaluating drug therapies on the post-acute phase of HF showed positive and/or satisfying results. Therefore, it is urgently required to establish an efficient treatment strategy at that phase. Sacubitril valsartan is an angiotensin receptor-neprilysin inhibitor that was approved in Japan in 2020 for patients who are taking standard care of HF.
In this investigator-initiated, multicenter, 8-week, randomized controlled study (PREMIER), the investigators try to assess the effect of in-hospital initiation of sacubitril valsartan, compared to standard HF treatment, in patients who were admitted due to worsening heart failure, on the NT-proBNP concentrations.
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
NT-proBNP ≥1200 pg/mL or BNP ≥300 pg/mL
Exclusion criteria
Switch from the ACE inhibitor or ARB that was taken before the allocation, and start oral administration twice daily with a starting dose of 50 mg of sacubitril valsartan. The duration of administration of the ACE inhibitor or ARB before allocation does not matter, but when switching from the ACE inhibitor, administration of sacubitril valsartan should be started at least 36 hours after the final administration of the drug.
After the start of administration, the dose is gradually increased to 100 mg and 200 mg once at intervals of 2 to 4 weeks, referring to the latest package insert and safety and tolerability standards. At that time, if the doctor in charge determines that the dose is not tolerated after the dose is increased, the dose may be reduced to the previous dose or the drug may be suspended depending on the medical situation.
Other names: Entresto® Tablets, Novartis Pharma K.K.
Standard treatment, other than Sacubitril Valsartan Sodium Hydrate, for HF
Other names: Angiotensin Converting Enzyme(ACE) inhibitor or Angiotensin II Receptor Blocker(ARB) etc.
Time frame: 8 weeks
Group ratio of the proportional change in the geometric mean of NT-proBNP concentrations from baseline to 8 weeks after protocol treatment initiation
Time frame: 4 weeks
Group ratio of the proportional change in the geometric mean of NT-proBNP concentrations from baseline to 4 weeks after protocol treatment initiation
Time frame: 8 weeks
Percentage of patients with at least a 50% reduction in NT-proBNP levels at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks
Percentage of patients with at least a 30% reduction in NT-proBNP levels at 4 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percentage of patients with at least a 40% reduction from baseline in mean NT-proBNP at 4 and 8 weeks after protocol treatment initiation
Time frame: 8 weeks
Amount of change in cardiac troponin T at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in cardiac troponin T at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in C-reactive protein at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in C-reactive protein at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in growth differentiation factor 15 at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in growth differentiation factor 15 at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in soluble suppression of tumorigenesis-2 at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in soluble suppression of tumorigenesis-2 at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in glycoalbumin at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in glycoalbumin at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in 1.5-anhydro-D-glucitol at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in 1.5-anhydro-D-glucitol at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in weight at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in weight at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in body mass index at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in body mass index at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in systolic blood pressure and diastolic blood pressure at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in systolic blood pressure and diastolic blood pressure at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in heart rate at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in heart rate at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in red blood cell at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in red blood cell at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in hemoglobin at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in hemoglobin at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in hematocrit at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in hematocrit at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in platelet at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in platelet at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in hemoglobin A1c at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in hemoglobin A1c at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in fasting glucose at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in fasting glucose at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in total cholesterol at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in total cholesterol at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in high-density lipoprotein cholesterol at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in high-density lipoprotein cholesterol at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in non-high-density lipoprotein cholesterol at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in non-high-density lipoprotein cholesterol at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in triglyceride at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in triglyceride at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in aspartate aminotransferase at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in aspartate aminotransferase at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in alanine aminotransferase at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in alanine aminotransferase at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in γ-glutamyl transpeptidase at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in γ-glutamyl transpeptidase at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in uric acid at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in uric acid at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in creatinine at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in creatinine at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in estimated glomerular filtration rate at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in estimated glomerular filtration rate at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in sodium at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in sodium at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in potassium at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in potassium at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in Fibrosis-4 at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in Fibrosis-4 at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in estimated plasma volume at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in estimated plasma volume at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Amount of change in New York Heart Association class at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 4 weeks, 8 weeks
Percent change in New York Heart Association class at 4 and 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in left ventricular end-diastolic volume at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in left ventricular end-diastolic volume at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in left ventricular end-systolic volume at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in left ventricular end-systolic volume at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in left ventricular ejection fraction at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in left ventricular ejection fraction at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in septal e' at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in septal e' at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in lateral e' at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in lateral e' at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in flow velocity pattern through the mitral orifice (E) at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in flow velocity pattern through the mitral orifice (E) at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in early mitral inflow velocity E and mitral annular early diastolic velocity e' at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in early mitral inflow velocity E and mitral annular early diastolic velocity e' at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in left ventricular mass index at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in left ventricular mass index at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in left atrial volume index at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in left atrial volume index at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in left ventricular outflow tract at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in left ventricular outflow tract at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in left ventricular outflow tract velocity time integral at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in left ventricular outflow tract velocity time integral at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in tricuspid regurgitation velocity at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in tricuspid regurgitation velocity at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in inferior vena cava diameter at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in inferior vena cava diameter at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in global longitudinal strain at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in global longitudinal strain at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in left atrial strain (2-chamber view and 4-chamber view) at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percent change in left atrial strain (2-chamber view and 4-chamber view) at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percentage of patients with at least a 50% respiratory variation in inferior vena cava diameter at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Amount of change in Kansas City Cardiomyopathy Questionnaire-12 score at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Percentage of patients with at least a 5-point increase in Kansas City Cardiomyopathy Questionnaire-12 score at 8 weeks after protocol treatment initiation compared with baseline
Time frame: 8 weeks
Time to first occurrences of the composite event of all-cause death or worsening heart failure event, defined as i) unplanned rehospitalization, ii) initiation of intravenous treatment (vasodilator or positive inotropic agent) for heart failure (during hospitalization: excludes at rehospitalization), iii) urgent visit due to heart failure requiring intravenous treatment (vasodilator, positive inotropic agent, or diuretic), or iv) initiation of oral diuretic (loop diuretic, thiazide-type diuretic, or tolvaptan) or at least a 50% increase in its dose (outpatient)
Time frame: 8 weeks
Total number of occurrences of the composite event of all-cause death or worsening heart failure events (first and recurrence)
Time frame: 8 weeks
Incidence of occurrences of the composite event of all-cause death or worsening heart failure events (first and recurrence)
Time frame: 8 weeks
Total number of occurrences of individual components of the following events: first and recurrent worsening heart failure events (i, ii, iii, and iv), all-cause mortality, and cardiovascular death
Time frame: 8 weeks
Incidence of occurrences of individual components of the following events: first and recurrent worsening heart failure events (i, ii, iii, and iv), all-cause mortality, and cardiovascular death
Time frame: 8 weeks
Time until occurrence of individual components of the following events: first and recurrent worsening heart failure events (i, ii, iii, and iv), all-cause mortality, and cardiovascular death
Time frame: 8 weeks
Total number of occurrences of specific adverse events, including decreased renal function (at least a 50% increase in serum creatinine or at least a 30% decrease in eGFR), hyperkalemia (serum potassium: 5.5 mEq/L or more), symptomatic hypotension, and angioedema
Time frame: 8 weeks
Time until occurrence of specific adverse events, including decreased renal function (at least a 50% increase in serum creatinine or at least a 30% decrease in eGFR), hyperkalemia (serum potassium: 5.5 mEq/L or more), symptomatic hypotension, and angioedema
Time frame: 8 weeks
Number of occurrences of other serious adverse events
Saga University
Other
An Investigator-initiated, Multicenter, Prospective, Randomized, Open-label, Blinded-endpoint Study to Assess the Effect of In-hospital Initiation of Sacubitril Valsartan on the NT-proBNP Concentrations in Patients Admitted Due to Acute Exacerbation of Heart Failure (PREMIER)
OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.
View the official ClinicalTrials.gov record (opens in a new tab)This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.
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