ACetazolamide in Patients With Heart Failure, to Decrease Weight and relIEVE Symptoms. (ACHIEVE)
Acute congestion is common in patients with heart failure (HF) and is associated with impaired renal function, reduced quality of life, hospital readmissions, and mortality. Current guidelines recommend optimal decongestion using diuretic therapy, mainly loop diuretics. Although acetazolamide has recently demonstrated efficacy in hospitalized patients, its role in ambulatory patients managed through remote telemonitoring remains to be established. This study aims to evaluate the efficacy of oral acetazolamide added to conventional treatment for decongesting ambulatory HF patients during congestive decompensations.
ACHIEVE is a Phase III multicenter, prospective, interventional, randomized, controlled, open-label superiority trial evaluating the efficacy of oral acetazolamide added to conventional treatment for decongestion in ambulatory patients with heart failure during congestive decompensation monitored by remote telemonitoring.
The primary objective is to assess, at Day 5, whether acetazolamide added to conventional treatment improves decongestion compared with standard treatment alone. Secondary objectives include evaluating efficacy, safety, and health economic outcomes, including quality of life, dyspnea, biological markers, unplanned consultations, hospitalizations, mortality, and hospital medical costs.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 3
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Clément Delmas, MD
- Email: delmas.clement@chu-toulouse.fr
Backup dei contatti dello studio
- Nome: François ROUBILLE, MD
- Numero di telefono: 04 67 33 31 82
- Email: f-roubille@chu-montpellier.fr
Luoghi di studio
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Amiens, Francia
- University Hospital Amiens-Picardie
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Contatto:
- Emmanuelle VERMES, MD
- Numero di telefono: 33 0322087311
- Email: vermes.emmanuelle@chu-amiens.fr
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Investigatore principale:
- Emmanuelle VERMES, MD
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Angers, Francia
- University Hospital Angers
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Contatto:
- Sylvain Grall, MD
- Numero di telefono: 33 0241353391
- Email: sygrall@chu-angers.fr
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Investigatore principale:
- Sylvain Grall, MD
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Avignon, Francia
- Avignon Hospital
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Investigatore principale:
- Stephane Andrieu, MD
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Contatto:
- Stephane Andrieu, MD
- Numero di telefono: 33 0432759283
- Email: protosavignon@yahoo.fr
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Besançon, Francia
- University Hospital Besançon
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Investigatore principale:
- Marie France Seronde, MD
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Contatto:
- Marie France Seronde, MD
- Numero di telefono: 33 0381668187
- Email: mfseronde@chu-besancon.fr
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Bordeaux, Francia
- University Hospital Bordeaux
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Contatto:
- Sylvain Ploux, MD
- Numero di telefono: 33 0524549197
- Email: sylvain.ploux@chu-bordeaux.fr
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Investigatore principale:
- Sylvain Ploux, MD
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Brest, Francia
- University Hospital Brest
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Contatto:
- Ombeline Paglia, MD
- Numero di telefono: 33 0298347505
- Email: ombeline.paglia@chu-brest.fr
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Investigatore principale:
- Ombeline Paglia, MD
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Béziers, Francia
- Hospital Beziers
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Contatto:
- Frédéric GEORGER, MD
- Numero di telefono: 33 0467357134
- Email: frederic.georger@ch-beziers.fr
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Investigatore principale:
- Frederic Georger, MD
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Caen, Francia
- University Hospital Caen
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Contatto:
- Laurence Herrou, MD
- Numero di telefono: 33 0231064307
- Email: herrou-l@chu-caen.fr
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Investigatore principale:
- Laurent Herrou, MD
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Chartres, Francia
- Chartres Hospital
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Contatto:
- Franck Albert, MD
- Numero di telefono: 33 0237303057
- Email: falbert@ch-chartres.fr
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Investigatore principale:
- Franck Albert, MD
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Cholet, Francia
- Cholet Hospital
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Contatto:
- Thi-thanh-hien Pham, MD
- Numero di telefono: 33 0241496985
- Email: thi-thanh-hien.pham@ch-cholet.fr
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Investigatore principale:
- Thi-thanh-hien Pham, MD
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Corbeil-Essonnes, Francia
- Sud Francilien Hospital
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Contatto:
- Fatiha Ait Yahia, MD
- Numero di telefono: 33 0161693019
- Email: fatiha.bouaraba@chsf.fr
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Investigatore principale:
- Fatiha Ait Yahia, MD
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Dreux, Francia
- Dreux Hospital
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Contatto:
- Dario BOTTIGLIERO, MD
- Numero di telefono: 33 0237515008
- Email: dbottigliero@ch-dreux.fr
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Investigatore principale:
- Dario BOTTIGLIERO, MD
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Grenoble, Francia
- University Hospital Grenoble Alpes
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Contatto:
- Muriel Salvat, MD
- Numero di telefono: 33 0476768888
- Email: MSalvat@chu-grenoble.fr
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Investigatore principale:
- Muriel Salvat, MD
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Grenoble, Francia
- Cardiovascular Institute - Grenoble Mutualist Hospital Group
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Contatto:
- Benjamin Casez, MD
- Numero di telefono: 33 0476707516
- Email: benjamin.casez@ghm-grenoble.fr
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Investigatore principale:
- Benjamin CASEZ, MD
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Le Kremlin-Bicêtre, Francia
- Bicetre Hospital
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Contatto:
- Emanuelle Berthelot, MD
- Numero di telefono: 33 0145213735
- Email: emmanuelle.berthelot@aphp.fr
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Investigatore principale:
- Emmanuelle Berthelot, MD
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Le Mans, Francia
- Pôle Santé Sud - Le Mans
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Contatto:
- Christophe Bachelet, MD
- Numero di telefono: 33 0243784590
- Email: christophe.bachelet@me.com
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Investigatore principale:
- Christophe Bachelet, MD
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Lyon, Francia
- Louis Pradel Hospital
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Contatto:
- Nathan Mewton, MD
- Numero di telefono: 33 0472357170
- Email: nathan.mewton@chu-lyon.fr
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Investigatore principale:
- Nathan Mewton, MD
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Montpellier, Francia
- University hospital Montpellier
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Investigatore principale:
- François Roubille, MD
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Contatto:
- François ROUBILLE, MD
- Numero di telefono: 33 04 67 33 31 82
- Email: f-roubille@chu-montpellier.fr
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Nancy, Francia
- Regional University Hospital Nancy
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Investigatore principale:
- Nicolas Girerd, MD
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Contatto:
- Nicolas Girerd, MD
- Numero di telefono: 33 0383157496
- Email: n.girerd@chru-nancy.fr
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Nantes, Francia
- The Confluent Private Hospital
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Contatto:
- Nicolas Jacob, MD
- Numero di telefono: 33 0228255115
- Email: njacob@vivalto-sante.com
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Investigatore principale:
- Nicolas Jacob, MD
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Nîmes, Francia
- University Hospital Nîmes
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Contatto:
- Elvira Prunet, MD
- Numero di telefono: 33 0466683116
- Email: elvira.prunet@chu-nimes.fr
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Investigatore principale:
- Elvira Prunet, MD
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Strasbourg, Francia
- Ellipse Center Strasbourg
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Contatto:
- Florian Zores, MD
- Numero di telefono: 33 0388859950
- Email: florian.zores@gmail.com
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Investigatore principale:
- Florian Zores, MD
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Toulon, Francia
- Sainte Musse Hospital Toulon
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Contatto:
- Jean-Michel Tartiere, MD
- Numero di telefono: 33 0494145931
- Email: jean-michel.tartiere@ch-toulon.fr
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Investigatore principale:
- Jean-Michel TARTIERE, MD
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Toulouse, Francia
- University Hospital toulouse
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Contatto:
- Clément Delmas, MD
- Email: delmas.clement@chu-toulouse.fr
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Contatto:
- Romain ITIER, MD
- Numero di telefono: 33 0561322103
- Email: itier.r@chu-toulouse.fr
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Investigatore principale:
- Romain ITIER
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Sub-investigatore:
- Clément DELMAS, MD
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Valenciennes, Francia
- Valenciennes Hospital
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Contatto:
- Thomas Mercier, MD
- Numero di telefono: 33 0327143041
- Email: mercier-t@ch-valenciennes.fr
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Investigatore principale:
- Thomas Mercier, MD
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Age ≥ 18
- Known HF with impaired, midly-reduced or preserved LVEF
- Under guideline directed medical therapy for HF according to ESC Heart Failure Guidelines applicable at inclusion
- Previously followed (or included at hospital discharge) by remote monitoring allowing daily weight by connected scale (i.e. Careline®, Optified-self®, NewCard®, Implicity®)
- Under furosemide diuretic treatment ≥ 20mg/day for at least 30 days prior to inclusion
- Current unplanned hospitalization or unplanned/emergent consultation for acute/decompensation HF
Exclusion Criteria:
- Subject unable to express their consent and sign informed consent form
- Subject not covered by public health insurance
- Refusal to participate (absence of informed consent).
- Subject under guardianship, legal protection, or deprived of liberty.
- Pregnant or breastfeeding women.
- Subject under law protection and prisoners
- Women of child bearing potential, unless they are using an effective method of birth control (i.e. oral contraceptives, implantable contraceptives, injectable contraceptives, transdermal contraceptives, intrauterine devices, male or female condoms with spermicide, abstinence, or a sterile sexual partner)
- Subject unable to comprehend or adhere to the protocol and follow-up
- Concurrent participation in another interventional study.
- Chronic ventricular assist device or heart transplant patients.
- Acute heart failure from recent acute coronary syndrome (< 1 month).
- Severe chronic renal failure or dialysis (GFR < 20 ml/min).
- History of renal colic, hyperchloremic acidosis and wheat allergy (other than coeliac disease)
- Known severe hepatic insufficiency defined by a PTT < 50% or a Child-Pugh score C and/or a known (clinial or biological) supplemented adrenal insufficiency
- Intolerance to sulphonamides
- Hypersensitivity to the active substance (Acetazolamide) or to any of the excipients (Calcium carbonate, wheat starch, gelatine, magnesium stearate)
- Concomitant use of carbamazepine or quinidinics (hydroquinidine, quinidine)
- Low cardiac output syndrome/cardiogenic shock.
- Current use of acetazolamide or any other carbonic anhydrase inhibitor, including but not limited to topical ophthalmic formulations (e.g., brinzolamide, dorzolamide, methazolamide)
- Concomitant use of lithium, valproic acid and valpromide
- Current use of high-dose aspirin (>300 mg/day).
Non-randomization criteria (Criteria should be controlled before patients' randomization) :
- False alarm
- Time between alarm and randomization > 48h
- Subject who declines his participation
- Loss of study treatments or unable to take it at D0
- Hemodynamic instability justifying an urgent hospitalization
- If applicable, positive urine pregnancy test
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: Experimental group - Acetazolamide
Ambulatory patients with decompensated heart failure receiving standard treatment with loop diuretics (furosemide) plus oral acetazolamide for up to 5 days.
Treatment effectiveness and safety are assessed daily using remote telemonitoring data.
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Standard treatment with loop diuretics (furosemide) administered for up to 5 days according to standard clinical practice.
Oral acetazolamide initiated at 500 mg (2 tablets) on Day 0. The dose may be adjusted every 48 hours according to the participant's clinical status until Day 5, if necessary.
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Comparatore attivo: Control group - Standard treatment
Ambulatory patients with decompensated heart failure receiving standard treatment with loop diuretics (furosemide) alone for up to 5 days.
Treatment effectiveness and safety are assessed daily using remote telemonitoring data.
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Standard treatment with loop diuretics (furosemide) administered for up to 5 days according to standard clinical practice.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Percentage of participants with weight loss >2 kg at Day
Lasso di tempo: Day 5
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Percentage of participants who achieve a body weight loss greater than 2 kg between baseline (Day 0) and Day 5, measured using a connected scale through the remote telemonitoring system.
Comparison between the experimental and control groups.
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Day 5
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Efficacy : Percentage of weight variation
Lasso di tempo: Day 0 to Day 5
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Percentage change in body weight between Day 0 and Day 5 measured using a connected scale through the remote telemonitoring system.
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Day 0 to Day 5
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Efficacy : Diuretic effectiveness
Lasso di tempo: Day 5
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Diuretic effectiveness assessed by urinary sodium excretion (natriuresis) corrected for loop diuretic exposure, expressed according to furosemide-equivalent dose administered up to Day 5.
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Day 5
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Efficacy : Change in NT-proBNP concentration
Lasso di tempo: Day 0 to Day 5
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Change in plasma NT-proBNP concentration measured from blood samples between baseline and Day 5.
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Day 0 to Day 5
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Efficacy : Change in health-related quality of life (EQ-5D-5L)
Lasso di tempo: Day 0 to Day 5
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Change in EQ-5D-5L score between baseline (Day 0) and Day 5.
The EQ-5D-5L is a validated generic quality-of-life questionnaire assessing five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression).Each question has 5 levels of answers: No problem, slight problems, moderate problems, severe problems and unable to/ extreme problems.
It also includes a visual analogue scale ranging from 0 (worst imaginable health state) to 100 (best imaginable health state).
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Day 0 to Day 5
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Efficacy : Change in dyspnea Visual Analogue Scale (VAS) score
Lasso di tempo: Day 0 to Day 5
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Change in dyspnea severity assessed using a Visual Analogue Scale (VAS) between baseline (Day 0) and Day 5.
The VAS ranges from 0 (no shortness of breath) to 10 (worst shortness of breath imaginable).
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Day 0 to Day 5
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Efficacy : Rate of unplanned consultation or hospitalization for heart failure
Lasso di tempo: Day 90
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Percentage of participants requiring an unplanned medical consultation, emergency department visit, or hospitalization for heart failure
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Day 90
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Efficacy : All-cause mortality
Lasso di tempo: Day 90
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Percentage of participants who die from any cause.
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Day 90
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Efficacy : All-cause mortality and Heart failure-related mortality
Lasso di tempo: Day 90
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Percentage of participants who die any cause or from heart failure during follow-up.
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Day 90
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Efficacy : Change in clinical congestion parameters
Lasso di tempo: At Day 15
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Evolution of clinical congestion including body weight, dyspnea VAS score, blood pressure, heart rate, and signs of right- and left-sided heart failure collected during follow-up visits.
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At Day 15
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Efficacy : Change in NT-proBNP concentration
Lasso di tempo: At Day 15
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Change in plasma NT-proBNP concentration measured on blood samples collected after the acute treatment period.
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At Day 15
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Safety : Change in serum sodium concentration
Lasso di tempo: Day 0 to Day 5
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Assessment of the change in serum sodium concentration between baseline Day 0 and Day 5 to evaluate electrolyte disturbances associated with treatment.
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Day 0 to Day 5
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Safety : Percentage of participants with serum sodium <125 mmol/L
Lasso di tempo: Day 5
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Percentage of participants presenting severe hyponatremia, defined as a serum sodium concentration below 125 mmol/L, on Day 5.
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Day 5
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Safety: Incidence of acute kidney injury (KDIGO stage ≥2)
Lasso di tempo: Day 0 to Day 5
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Percentage of participants developing acute kidney injury defined as Kidney Disease: Improving Global Outcomes (KDIGO) stage 2 or higher between D0 and D5.
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Day 0 to Day 5
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Safety : Change in serum potassium concentration
Lasso di tempo: Day 0 to Day 5
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Assessment of the change in serum potassium concentration between baseline Day 0 and Day 5 to evaluate treatment related electrolyte abnormalities.
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Day 0 to Day 5
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Safety: Percentage of participants with serum potassium <2.5 mmol/L
Lasso di tempo: Day 5
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Percentage of participants presenting severe hypokalemia, defined as a serum potassium concentration below 2.5 mmol/L, on Day 5.
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Day 5
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Safety: Change in serum bicarbonate concentration from Day 0 to Day 5
Lasso di tempo: Day 0 to Day 5
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Assessment of the change in serum bicarbonate concentration between baseline Day 0 and Day 5 to evaluate metabolic changes associated with treatment.
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Day 0 to Day 5
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Percentage of participants with serum bicarbonate <20 mmol/L
Lasso di tempo: Day 5
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Percentage of participants presenting serum bicarbonate concentrations below 20 mmol/L on Day 5.
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Day 5
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Safety: Change in systolic blood pressure
Lasso di tempo: Day 0 to Day 5
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Assessment of the change in systolic blood pressure between baseline Day 0 and Day 5 during treatment.
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Day 0 to Day 5
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Safety: Percentage of participants with systolic blood pressure <90 mmHg
Lasso di tempo: Day 0 to day 5
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Percentage of participants presenting systolic blood pressure below 90 mmHg during treatment.
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Day 0 to day 5
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Safety: Incidence of low cardiac output or cardiogenic shock
Lasso di tempo: Day 0 to Day 5
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Percentage of participants developing low cardiac output syndrome or cardiogenic shock between D0 and D5.
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Day 0 to Day 5
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Safety: Hospitalization due to treatment failure or poor treatment tolerance
Lasso di tempo: Day 5 and Day 15
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Percentage of participants requiring hospitalization because of treatment failure or poor treatment tolerance.
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Day 5 and Day 15
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Medicoeconomic: Hospital medical costs
Lasso di tempo: Day 90
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Difference in direct hospital medical costs related to unplanned consultations, emergency department visits, or hospitalizations between the experimental and control groups.
Costs will be assessed using actual reimbursement tariffs and hospital revenues.
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Day 90
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Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Direttore dello studio: François ROUBILLE, MD, University Hospital, Montpellier
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Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- RECHMPL24_0295
- 2025-524344-35-00 (Ctis)
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