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Furosemide vs Placebo in Severe Preeclampsia Postpartum (FUROPE)

9. června 2026 aktualizováno: Ricardo A Gutierrez Ramirez, MD, MSc, FACOG, Universidad Nacional Autonoma de Honduras

Furosemide Oral Versus Placebo for Reduction of Hospital Length of Stay in Postpartum Women With Severe Preeclampsia: A Double-Blind, Randomized Controlled Trial

This randomized, double-blind, placebo-controlled trial evaluates whether oral furosemide 40 mg, initiated 12 hours postpartum, reduces hospital length of stay compared to placebo (folic acid 5 mg) in postpartum women with severe preeclampsia. Secondary outcomes include need for rescue antihypertensive medications, weight reduction, and metabolic safety (hypokalemia, renal function). A total of 186 participants (93 per arm) will be enrolled across two hospitals in Honduras.

Přehled studie

Postavení

Zatím nenabíráme

Detailní popis

Background: Preeclampsia is a leading cause of maternal morbidity worldwide. Postpartum management focuses on blood pressure control and resolution of endothelial dysfunction. Loop diuretics like furosemide may accelerate normalization of intravascular volume and blood pressure, potentially reducing hospital stay.

Hypothesis: Furosemide 40 mg oral once daily reduces total postpartum hospital hours compared to placebo.

Study Design: Phase 2, randomized, double-blind, placebo-controlled, parallel-group trial.

Setting: Hospital Materno Infantil and Instituto Hondureño de Seguridad Social, Honduras.

Interventions:

Experimental: Furosemide 40 mg oral every 24 hours, starting at 12 hours postpartum, continued until hospital discharge.

Placebo: Folic acid 5 mg oral (identical appearance, packaging, and administration schedule).

Blinding: Double-blind. Only an independent pharmacist knows group assignment. Blinding is broken only for life-threatening adverse events.

Follow-up: Entirely inpatient, from enrollment (12 hours postpartum) until hospital discharge (estimated 3-7 days).

Typ studie

Intervenční

Zápis (Odhadovaný)

186

Fáze

  • Fáze 2

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Studijní místa

    • Francisco Morazán Department
      • Tegucigalpa, Francisco Morazán Department, Honduras, 11101
        • Hospital Escuela
        • Kontakt:
        • Vrchní vyšetřovatel:
          • Francisco J. Salgado Turcios, MD
        • Vrchní vyšetřovatel:
          • Andrés F. García Mejía, MD
        • Dílčí vyšetřovatel:
          • Doria A. Carrasco, MD, MSc.
        • Dílčí vyšetřovatel:
          • Sobeyda Lopez, MD

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dítě
  • Dospělý

Přijímá zdravé dobrovolníky

Ne

Popis

Inclusion Criteria:

  • Signed informed consent (assent for minors 14-17 years with parental/guardian consent)
  • Confirmed severe preeclampsia (BP ≥160/110 mmHg, or lower BP with thrombocytopenia, hepatic dysfunction, renal insufficiency, pulmonary edema, or cerebral/visual symptoms)
  • Postpartum (12-24 hours after delivery, vaginal or cesarean)
  • Hemodynamically stable (no vasopressors for ≥6 hours)
  • Preserved diuresis (>30 mL/hour for ≥6 hours)
  • Serum creatinine <0.8 mg/dL

Exclusion Criteria:

  • Current or chronic diuretic use (before or during pregnancy)
  • Known allergy to sulfonamides or furosemide
  • Active febrile illness
  • Known chronic kidney disease (eGFR <60 mL/min/1.73m²)
  • Participation in another interventional trial
  • Pregnancy (current - not applicable postpartum, but excludes undiagnosed concurrent pregnancy)

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Trojnásobný

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Furosemide
Every 24 hours starting at 12 hours postpartum until discharge
Furosemide 40 mg tablet, oral, once daily. First dose administered exactly 12 hours postpartum (vaginal or cesarean). Continued every 24 hours until hospital discharge, defined as blood pressure <140/90 mmHg for ≥24 hours without rescue antihypertensives. Population: severe preeclampsia (BP ≥160/110 mmHg OR lower BP with thrombocytopenia, hepatic dysfunction, renal insufficiency, pulmonary edema, or cerebral/visual symptoms). Setting: postpartum wards in two public hospitals in Honduras. Rescue medication: labetalol or hydralazine for BP >160/110 mmHg, deferred ≥2 hours after study drug when possible. Placebo comparator: folic acid 5 mg orally every 24 hours, identical appearance, packaging, and schedule. What distinguishes this intervention: first postpartum diuretic trial in severe preeclampsia with hospital length of stay as primary endpoint in a low-middle income country setting.
Komparátor placeba: Placebo
Folic acid, 5 mg per day Every 24 hours starting at 12 hours postpartum until discharge
Folic acid 5 mg oral once daily, starting at exactly 12 hours postpartum until hospital discharge (BP <140/90 mmHg for ≥24 hours without rescue drugs). Population: severe preeclampsia. Setting: public hospitals, Honduras. Rescue: labetalor hydralazine for BP >160/110 mmHg, deferred ≥2 hours post-dose. Active comparator: furosemide 40 mg oral, identical appearance and schedule. Folic acid has no antihypertensive or diuretic effects in postpartum women, serving as an appropriate placebo.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Hospital Length of Stay (Hours)
Časové okno: From first study dose (12 hours postpartum) up to hospital discharge, approximately 3 to 14 days
Total hours from first study dose (administered at 12 hours postpartum) to hospital discharge. Discharge is defined as achievement and maintenance of blood pressure <140/90 mmHg for at least 24 consecutive hours without need for rescue antihypertensive medication. Rescue medication is defined as any extra dose of labetalol or hydralazine administered for hypertensive crisis (blood pressure >160/110 mmHg). Time is measured in hours from the moment of first dose (hour 0) until the moment discharge orders are written. If a patient requires rescue medication, the clock does not reset; discharge criteria must still be met for 24 hours without rescue.
From first study dose (12 hours postpartum) up to hospital discharge, approximately 3 to 14 days

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Proportion Requiring Rescue Antihypertensive Medication
Časové okno: From first study dose (12 hours postpartum) until hospital discharge, approximately 3 to 14 days
Percentage of participants in each arm who require at least one dose of rescue antihypertensive medication (labetalol or hydralazine) during hospitalization. Rescue medication is indicated for hypertensive crisis defined as systolic blood pressure >160 mmHg or diastolic blood pressure >110 mmHg at any time after study drug administration. The proportion is calculated as number of participants receiving any rescue dose divided by total participants in the arm.
From first study dose (12 hours postpartum) until hospital discharge, approximately 3 to 14 days
Weight Reduction (Delta Weight in kg)
Časové okno: Baseline (12 hours postpartum) and at hospital discharge (approximately 3 to 14 days later)
Absolute difference between baseline weight (measured at 12 hours postpartum, immediately before first study dose) and weight at hospital discharge (measured on the morning of discharge day). Weight is measured in kilograms using the same calibrated scale for each participant. Delta weight is calculated as baseline weight minus discharge weight. A positive value indicates weight loss.
Baseline (12 hours postpartum) and at hospital discharge (approximately 3 to 14 days later)
Incidence of Hypokalemia
Časové okno: At 48 hours after first study dose or at hospital discharge (approximately 3 to 14 days)
Proportion of participants in each arm developing hypokalemia, defined as serum potassium <3.0 mEq/L. Blood sample is drawn at 48 hours after first study dose or at hospital discharge (whichever occurs first). Hypokalemia is considered an adverse event of special interest given furosemide's mechanism of action as a loop diuretic. Severe hypokalemia (<2.5 mEq/L) triggers unblinding and protocol-defined management.
At 48 hours after first study dose or at hospital discharge (approximately 3 to 14 days)
Renal Function Deterioration
Časové okno: Baseline (12 hours postpartum) and at 48 hours or hospital discharge (approximately 3 to 14 days)
Change in serum creatinine from baseline to follow-up measurement. Baseline creatinine is measured at enrollment (12 hours postpartum, before first dose). Follow-up creatinine is measured at 48 hours after first dose or at hospital discharge (whichever occurs first). Renal deterioration is defined as an increase in serum creatinine of ≥0.3 mg/dL from baseline or a percentage increase of ≥50%. Mean change (absolute and percentage) is compared between groups.
Baseline (12 hours postpartum) and at 48 hours or hospital discharge (approximately 3 to 14 days)
Spontaneously Reported Adverse Events
Časové okno: From first study dose (12 hours postpartum) until hospital discharge, daily assessment, approximately 3 to 14 days
Incidence of spontaneously reported adverse events potentially related to furosemide, including dizziness/orthostatic hypotension, muscle cramps, and palpitations. Participants are asked daily "Have you experienced any unusual symptoms since the last dose?" Responses are recorded regardless of suspected relationship to study drug. Severity is graded as mild (minimal or no treatment needed), moderate (some interference with daily activities), or severe (significant interference).
From first study dose (12 hours postpartum) until hospital discharge, daily assessment, approximately 3 to 14 days
Antihypertensive-Free Discharge
Časové okno: At hospital discharge, approximately 3 to 14 days after first study dose
Proportion of participants discharged from the hospital without requiring any maintenance antihypertensive medication. Maintenance antihypertensives are defined as scheduled oral medications (not rescue doses) intended to control blood pressure after discharge. Participants who require continued antihypertensive therapy at discharge (any dose, any agent) are considered not achieving antihypertensive-free discharge.
At hospital discharge, approximately 3 to 14 days after first study dose

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Publikace a užitečné odkazy

Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

15. června 2026

Primární dokončení (Odhadovaný)

31. prosince 2026

Dokončení studie (Odhadovaný)

15. ledna 2027

Termíny zápisu do studia

První předloženo

9. června 2026

První předloženo, které splnilo kritéria kontroly kvality

9. června 2026

První zveřejněno (Aktuální)

15. června 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

15. června 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

9. června 2026

Naposledy ověřeno

1. června 2026

Více informací

Termíny související s touto studií

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

ANO

Popis plánu IPD

De-identified individual participant data (IPD) for all primary and secondary outcome measures will be shared publicly via Mendeley Data repository. The dataset will include: participant demographics, baseline clinical characteristics, primary outcome (hospital length of stay in hours), secondary outcomes (rescue medication requirement, weight change, laboratory values including potassium and creatinine, adverse events, discharge antihypertensive status), and protocol deviations. Data will be anonymized with no direct identifiers (name, medical record number, date of birth). Each participant will be identified by a unique study code only.

Timeline: Data will be deposited within 12 months after primary results publication. The repository link will be included in the primary publication and in this ClinicalTrials.gov record when available.

Supporting documents also available via Mendeley Data: Study protocol (v1.0), Statistical Analysis Plan (SAP), and blank informed consent form

Časový rámec sdílení IPD

Available starting 12 months after primary results publication. Available for 5 years thereafter.

Kritéria přístupu pro sdílení IPD

No registration or authorization required for download. Data will be under a CC BY-NC 4.0 license (Creative Commons Attribution-NonCommercial 4.0 International), allowing other researchers to use, share, and adapt the data for non-commercial purposes with proper attribution.

Typ podpůrných informací pro sdílení IPD

  • CSR

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

produkt vyrobený a vyvážený z USA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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