- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04050904
Chronic Heart Failure Therapy Optimization With CardioRenal Remote Monitoring System (HERMESHF) (HERMESHF)
Study Overview
Detailed Description
The study will take place as follows :
The remote monitoring of the biomarkers (5 days a week, between 7am - 12 midday). The home-based monitoring of congestion by Hb and Hte, eGFR using the CKD EPI formula (creatinine) and potassium variables will be measured with point of care devices, after minimally invasive blood sampling operated by the healthcare professional who will manually enter the data in the Information System.
2. ExpHeart is composed of an Information System (web application) and an algorithm, the Expert System, embedded on the information system. The Information System is a cyber-securised web application and the Expert System uses a proprietary therapeutic algorithm to optimize pharmacological HF treatment. The Expert System is based on the analysis of a continuously updated clinical database integrating the patient's electronic medical record (managed by the Information System). The Expert System will generate prescription recommendations directed to the treating investigator through the Information System. The Expert System recommendations are based on ESC clinical guidelines (Annex II). This evaluated solution Expheart is not CE marked yet.
3. Decision on treatment update and/or optimization will be operated by physicians and healthcare professionals who will monitor compliance with the study protocol including the smooth functioning of bilateral patientinvestigator communication, i.e. (i) receipt by the investigator of recommendations from Expheart solution, (ii) adequate action/decision of the investigator and (iii) implementation of the appropriate action at the patient level.
The Investigator will inform the patient's treating physician/General practitioner (by phone and mail) about the participation of his/her patient to the study and will inform him that any HF treatment prescription change will be performed by him/her during the study period.
Moreover, in case of any technical difficulty, assistance will be provided by a dedicated call center, serviced daily by the promotor (Monday to Friday, support@cardio-renal.com).
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Ursula Morjaria, MBA
- Phone Number: 0032477233270
- Email: umorjaria@cardio-renal.com
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Subjects who understand the study procedures and agree to participate by providing informed consent.
- Male or female aged ≥18 years
Subjects with worsening HF:
- Currently admitted to hospital with worsening heart failure, OR
- Discharged within 2 weeks from hospitalization with worsening heart failure AND
- HF with reduced ejection fraction (i.e. ejection fraction ≤ 35% documented within 6 months before enrolment)
- NT-proBNP > 1000 pg/ml, or BNP > 200 pg/ml. For subjects with atrial fibrillation, BNP must be > 700 pg/ml or NT-proBNP > 2500 pg/ml.
Receiving suboptimal therapy i.e. no doses or doses < 50% of guideline target optimal of ACE inhibitors or ARB or ARNI or MRA (as per ESC guidelines recommendations, Annex II) AND at risk of developing hyperkalaemia or worsening renal function i.e. ANY of the following:
- documented history of hyperkalaemia or of worsening renal function leading to ACE-I or ARB or ARNI or MRA down-titration or discontinuation,
- age > 75 years,
- eGFR < 50 ml/min/1.73 m2 anytime during hospitalization (using the CKD EPI formula),
- diabetes.
Exclusion Criteria:
- Subjects with newly diagnosed heart failure within the past 3 months.
- Subjects known to be poorly adherent to their HF medications/treatment regimen.
- Subjects who have had a non-cardiac surgical procedure or cardiac-related interventional procedure (for example but not limited to angiogram, CABG, angioplasty or pacemaker insertion) within the past 30 days.
- Subjects who have had an ACS, or MI, within the past 30 days.
- Subjects with eGFR <30 ml/min/1.73m2 (using CKD EPI formula)
- Subjects with life expectancy less than 3 months in the opinion of the investigator
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: ExpHeart
The Information System is a cyber-securised web application and the Expert System uses a proprietary therapeutic algorithm to optimize pharmacological HF treatment.
|
ExpHeart is composed of an Information System (web application) and an algorithm, the Expert System, embedded on the Information System.
The Information System is a cyber-securised web application and the Expert System uses a proprietary therapeutic algorithm to optimize pharmacological HF treatment.
The Expert System is based on the analysis of a continuously updated clinical database integrating the patient's electronic medical record (managed by the Information System).
The Expert System will generate prescription recommendations directed to the treating investigator through the Information System.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Hospitalization
Time Frame: 5 weeks
|
All cause hospitalization (total number of participants hospitalized for any cause)
|
5 weeks
|
Mortality (number of all cause death)
Time Frame: 5 weeks
|
All cause death
|
5 weeks
|
Heart failure hospitalization (number of patients hospitalized for heart failure)
Time Frame: 5 weeks
|
Heart failure hospitalization defined as:
|
5 weeks
|
Hyperkalemia (number of participants with episode of hyperkaliemia)
Time Frame: 5 weeks
|
Hyperkalemia >6 mmol/L (confirmed by immediate recheck on site with vein puncture by the study nurse)
|
5 weeks
|
Hypokalemia (number of participants with episode of hypokaliemia)
Time Frame: 5 weeks
|
Hypokalemia <3.5 mmol/L (confirmed by immediate recheck on site with vein puncture by the study nurse)
|
5 weeks
|
Renal function
Time Frame: 5 weeks
|
Number of participants with at least one episode of worsening renal function >50 %, >100 %
|
5 weeks
|
Feasibility outcome
Time Frame: 5 weeks
|
Number of successful procedures during each study steps from puncture and sampling process to implementation of the specific action at the patient level
|
5 weeks
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pharmacotherapy
Time Frame: 5 weeks
|
Number of participants with changes from baseline to 5 weeks post enrollment of doses of ACE inhibitors or ARB or ARNI or MRAs and of loop diuretics
|
5 weeks
|
Dose titration
Time Frame: 5 weeks
|
Frequency of dose titration of ACE inhibitors or ARB or ARNI or MRAs and of loop diuretics
|
5 weeks
|
Rate of patients with optimal therapy
Time Frame: 5 weeks
|
Rate of patients receiving optimal therapy of ACE inhibitors or ARB or ARNI or MRAs (i.e.
receiving doses > 50% of guideline target doses), alive, and not hospitalized for heart failure
|
5 weeks
|
Congestion
Time Frame: 5 weeks
|
Changes from baseline to 5 weeks post enrollment in congestion score as assessed by lung comet ultrasound
|
5 weeks
|
Changes in BNP
Time Frame: 5 weeks
|
Changes from baseline to 5 weeks post enrollment in blood levels of BNP (pg/mL)
|
5 weeks
|
Hemoglobin
Time Frame: 5 weeks
|
Changes from baseline to 5 weeks in blood hemoglobin concentration (g/L)
|
5 weeks
|
Hemoglobin
Time Frame: 5 weeks
|
Changes from baseline to 5 weeks in hematocrit (%)
|
5 weeks
|
Renal function
Time Frame: 5 weeks
|
Changes from baseline to 5 weeks in eGFR (ml/min/1.7 m2) (using the CKD EPI formula)
|
5 weeks
|
Blood potassium
Time Frame: 5 weeks
|
Changes from baseline to 5 weeks in blood potassium (mmol/L)
|
5 weeks
|
Patient experience
Time Frame: 5 weeks
|
Sociology survey with questionnaire on subjective experience (Optional sub-study) Changes from baseline to 5 weeks in Health-related Quality of life, measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ)
|
5 weeks
|
Exploratory pathophysiological outcomes
Time Frame: 5 weeks
|
Correlation between changes in Hb and hematocrit with the following parameters:
|
5 weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Alexandre Mebazaa, MD, Hôpital Lariboisière
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- CR-2018-001
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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