Metformin Pharmacokinetics in Patients With Chronic and Acute Heart Failure (MetKin)
Metformin in Patients With Chronic and Acute Heart Failure: Pharmacokinetics and Polymorphisms in Genes Encoding Membrane Metformin Transporter Proteins
The study evaluates the pharmacokinetics of metformin in heart failure patients in acute and chronic state in relation to metformin transporter genotypes. Participants have heart failure and type 2 diabetes treated with metformin.
Hypothesis:
Primary: The renal clearance of metformin is decreased in acute state of congestive heart failure compared with chronic state.
Secondary: Metformin trough values in HF patients are influenced by polymorphisms in transporter genes relevant to the pharmacokinetics of metformin.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Background: Heart failure (HF) is a common disease and diabetes/insulin resistance are present in approximately 50 % of HF patients. Metformin is the most commonly prescribed oral anti-diabetic drug, and a huge inter-individual variability in trough steady-state metformin concentration in type 2 diabetics have been demonstrated. Genetic polymorphisms in metformin transporter genes are likely to have a direct impact on metformin pharmacokinetics and variability in drug responses, but the influence of polymorphisms in these transporter genes on circulating metformin levels is presently unknown in HF patients.
Objectives:
A) To compare the pharmacokinetics of metformin in 12 diabetic patients with HF in acute and chronic state.
B) To investigate the influence of polymorphisms in genes encoding the metformin transporter proteins on metformin trough levels in 150 diabetic HF patients.
Design: An open, single-center study enrolling 12 patients with acute heart failure (study A) and 150 patients with stable chronic heart failure (study B). The participants have diabetes already treated with metformin prior to inclusion. Through repeated blood draws, the concentration of metformin will be determined along with genotyping for metformin transporter genes.
Primary outcome:
Study A: Changes in renal clearance of metformin between patients with acute and chronic heart failure.
Study B: Mean trough steady-state concentrations of metformin with emphasis on the intra-interindividual variability in HF patients.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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-
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Aarhus N, Denmark, 8200
- Aarhus University Hospital, Department of Cardiology, Palle Juul-Jensens Boulevard 99
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with heart failure
- LVEF < 45% within 12 months prior to inclusion
- NYHA-class I, II, III or IV
- Ability to understand the written patient information and to give informed consent
- Diabetes Type 2 (and in metformin treatment for > 1 month)
- Stable dosage of metformin treatment for at least 1 week prior to examination
Exclusion Criteria:
- Age < 18 years
- Current abuse of alcohol or drugs
Study Plan
How is the study designed?
Design Details
- Primary Purpose: OTHER
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: Interventional
All participants
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Changes in renal clearance of metformin between patients with acute and chronic heart failure.
Time Frame: approximately 2 weeks
|
approximately 2 weeks
|
|
Mean trough steady-state concentrations of metformin with emphasis on the intra-interindividual variability in HF patients
Time Frame: 3 weeks
|
3 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ANTICIPATED)
Primary Completion
Study Completion (ANTICIPATED)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 50268-20150921
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