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Effects of Dapagliflozin, Semaglutide, and Their Combination in Heart Failure Patients With Prosthetic Heart Valves (SYNCARDIA-HF)

20. maj 2026 opdateret af: Mohsen Abdelaziz Mohsen Morshedi, Kafrelsheikh University

A Prospective, Randomized, Open-Label, Blinded-Endpoint, Parallel-Group, Phase IIb Proof-of-Concept Clinical Trial of Semaglutide Added to Dapagliflozin Versus Dapagliflozin Monotherapy in Patients With Heart Failure and Previous Surgical Prosthetic Valve Replacement

This study evaluates whether adding a medication called semaglutide to an existing treatment of dapagliflozin provides better outcomes for patients with heart failure who have previously undergone surgical heart valve replacement.

Dapagliflozin is already a standard treatment for managing heart failure symptoms. However, many heart failure patients-especially those who have had surgical prosthetic valve replacements-continue to experience persistent symptoms, fluid retention, and a decline in their quality of life. This trial aims to investigate whether combining dapagliflozin with semaglutide (a medication widely used for metabolic health and weight management) can safely offer additional clinical benefits.

Participants in this study are divided into two groups:

Group 1 (Combination Therapy): Receives semaglutide added to their standard dapagliflozin routine.

Group 2 (Monotherapy Control): Continues receiving dapagliflozin alone.

Researchers will monitor both groups over a set treatment period to compare changes in heart function, symptom management, fluid control, and overall quality of life to see if the combination approach is more effective than standard treatment.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a single-center, prospective, randomized, open-label, blinded-endpoint (PROBE), parallel-group, Phase IIb proof-of-concept clinical trial conducted at Kafrelsheikh University Hospital. The study evaluates the clinical efficacy, safety, and tolerability of combining the glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide with the sodium-glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin, compared against dapagliflozin monotherapy, in patients presenting with heart failure (HF) who have a history of surgical prosthetic heart valve replacement.

A total of 160 eligible patients are randomized in a strict 1:1 allocation ratio to one of two parallel treatment arms:

Combination Therapy Arm: Patients receive oral semaglutide escalated according to standard clinical protocol, administered in addition to a stable baseline regimen of dapagliflozin (10 mg once daily).

Monotherapy Control Arm: Patients continue to receive standard-of-care dapagliflozin monotherapy (10 mg once daily).

The primary objective is to determine if dual metabolic pathway modulation via combined SGLT2 inhibition and GLP-1 receptor agonism provides superior optimization of cardiovascular outcomes over SGLT2 inhibition alone. Key secondary and surrogate clinical outcomes assessed across the treatment duration include changes in New York Heart Association (NYHA) functional class, evaluation of fluid retention and diuretic requirements, echocardiographic parameters evaluating cardiac structure and function, and standardized quality-of-life assessment scores. Safety and tolerability profiles-including adverse event rates and systemic hemodynamic responses-will be rigorously monitored across both treatment cohorts.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

160

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Egypten
    • Kafrelsheikh Governrate
      • Kafr ash Shaykh, Kafrelsheikh Governrate, Egypten, 33511
        • Kafrelsheikh univeristy hospital, Faculty of medicine, Kafrelsheikh univeristy

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

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Beskrivelse

Inclusion Criteria:

Age is at least 18 years at the time of screening. Confirmed diagnosis of heart failure. Documented history of surgical prosthetic heart valve replacement. Patient is currently on a stable baseline regimen of dapagliflozin (10 mg once daily).

Willing and able to provide written informed consent prior to any study-related procedures.

Exclusion Criteria:

  • Known hypersensitivity or allergy to semaglutide, dapagliflozin, or any of their excipients.

Type 1 diabetes mellitus.

Severe renal impairment (e.g., eGFR < 25 or 30 mL/min/1.73m², depending on your exact protocol threshold) or currently requiring dialysis.

Active pregnancy, breastfeeding, or intent to become pregnant during the 12-week study period.

Participation in another conflicting interventional clinical trial within the past 30 days.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Combination Therapy Arm
Patients receive subcutaneous (s.c.) semaglutide escalated according to standard clinical protocol, initiated at a dose of 0.25 mg once weekly for 4 weeks, followed by a stepwise dose escalation every 4 weeks to 0.5 mg, then 1.0 mg if tolerated, administered in addition to a stable baseline regimen of dapagliflozin (10 mg once daily).
Medicin: semaglutide
Subcutaneous (s.c.) semaglutide initiated at a dose of 0.25 mg once weekly for 4 weeks, followed by standard clinical titration (escalating every 4 weeks through 0.5 mg, then 1.0 mg, up to the maximum tolerated maintenance dose) for the duration of the study period.
Medicin: Dapagliflozin (10mg Tab)
Sodium-glucose cotransporter 2 (SGLT2) inhibitor administered orally at a stable, standard-of-care dose of 10 mg once daily.
Aktiv komparator: Monotherapy Control Arm
Patients continue to receive standard-of-care dapagliflozin monotherapy (10 mg once daily).
Medicin: Dapagliflozin (10mg Tab)
Sodium-glucose cotransporter 2 (SGLT2) inhibitor administered orally at a stable, standard-of-care dose of 10 mg once daily.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change from Baseline in Left Ventricular Global Longitudinal Strain (LV-GLS) assessed by echocardiography
Tidsramme: Baseline and 12 weeks

Left ventricular global longitudinal strain (LV-GLS) will be calculated as the average peak systolic strain using a 17-segment model derived from apical two-, three-, and four-chamber views. All studies are analyzed offline using validated software by experienced echocardiographers blinded to treatment allocation.

Unit of Measure: Percentage (%), Strain is expressed as a percentage of deformation, typically a negative value where a more negative number indicates better systolic function.
Baseline and 12 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels.
Tidsramme: Baseline and 12 weeks.
NT-proBNP is a well-established blood biomarker used to monitor myocardial wall stress and the severity of heart failure. Blood samples are drawn to measure the mean change in NT-proBNP levels (measured in pg/mL) from randomization baseline to the final follow-up.
Baseline and 12 weeks.
Change from baseline in the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS).
Tidsramme: Baseline and 12 weeks.
The KCCQ-CSS is a patient-reported health status instrument specifically designed to measure the symptoms and physical limitations associated with heart failure. Scores range from 0 to 100, where lower scores reflect more severe symptoms/limitations and higher scores indicate better health status. This measure evaluates the efficacy of adding subcutaneous semaglutide to dapagliflozin compared to dapagliflozin alone by calculating the mean change in KCCQ-CSS from the randomization baseline to the final follow-up.
Baseline and 12 weeks.
Change from baseline in Six-Minute Walk Test (6MWT) distance.
Tidsramme: Baseline and 12 weeks.
The 6MWT evaluates objective functional capacity and exercise tolerance in heart failure patients. The test measures the maximum distance (in meters) a participant can quickly walk on a flat, hard surface in a period of 6 minutes. This endpoint calculates the mean change in walked distance from baseline to the end of the study.
Baseline and 12 weeks.
Change from Baseline in E/e' Ratio assessed by echocardiography
Tidsramme: Baseline and 12 weeks
Calculated using transmitral Doppler peak early filling velocity (E) in cm/s and tissue Doppler early diastolic mitral annular velocity (e') in cm/s to evaluate left ventricular diastolic filling pressure.
Baseline and 12 weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Kafrelsheikh University

Efterforskere

  • Studiestol: Reda B Bastawisy, MD (Professor), Faculty of medicine, Kafrelshiekh university
  • Studiestol: Mohamed K Salama, MD (Assistant professor), Faculty of medicine, Kafrelshiekh university
  • Studiestol: Khaled E Hamada, MD (cardiology), Faculty of medicine, Kafrelshiekh university

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

2. juni 2025

Primær færdiggørelse (Faktiske)

29. april 2026

Studieafslutning (Faktiske)

29. april 2026

Datoer for studieregistrering

Først indsendt

20. maj 2026

Først indsendt, der opfyldte QC-kriterier

20. maj 2026

Først opslået (Faktiske)

27. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

27. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

20. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • KFSIRB200-648

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

De-identified individual participant data (including baseline characteristics, outcome measures, and relevant clinical variables) will be made available upon reasonable request after publication of the study results.

IPD-delingstidsramme

Data will be available starting 6 months after publication and will remain available for up to 2 years.

IPD-delingsadgangskriterier

Access will be granted to qualified researchers upon reasonable request, subject to approval by the principal investigator and institutional ethics committee, and after signing a data sharing agreement.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP

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