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Natriuresis With Acetazolamide or SGLT2 Inhibitors Added to Intravenous Loop Diuretics in Decompensated Heart Failure (GLIDE-DHF)

5 novembre 2026 aggiornato da: Universidade do Porto

Natriuresis in Decompensated Heart Failure Patients Treated With Intravenous Loop Diuretics Alone or in Combination With an SGLT2 Inhibitor or Acetazolamide: a Single-Center, Prospective, Open-Label, Non-Randomized, Controlled Interventional Study (GLiflozin or AcetazolamIDE on Top of Loop Diuretics in Decompensated Heart Failure)

The GLIDE-DHF study compares the natriuretic effect of adding acetazolamide or a sodium-glucose co-transporter 2 inhibitor (SGLT2i) to intravenous loop diuretics, versus intravenous loop diuretics alone, in patients admitted to the emergency department with acute decompensated heart failure. Natriuresis is assessed by spot urinary sodium concentration measured 6 hours after the first study treatment. The study also evaluates changes in urinary and serum electrolytes, kidney function, blood pressure, clinical congestion and safety during the first 3 days of treatment.

Panoramica dello studio

Stato

Attivo, non reclutante

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Effettivo)

68

Fase

  • Fase 4

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

    • Porto District
      • Porto, Porto District, Portogallo, 4200-319
        • Unidade Local de Saúde São João

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • Age ≥18 years
  • Admission to the emergency department with a primary diagnosis of decompensated heart failure
  • Inclusion within the first 24 hours after emergency department admission
  • In patients who received intravenous loop diuretics before inclusion, baseline urine sample collected at least 6 hours after the last loop diuretic dose
  • Written informed consent

Exclusion Criteria:

  • Hemodynamic instability (systolic blood pressure <90 mmHg and/or serum lactate >2 mmol/L)
  • Decompensated heart failure in the setting of an acute coronary syndrome
  • Chronic maintenance therapy with an SGLT2 inhibitor or acetazolamide before the current episode
  • Baseline estimated glomerular filtration rate (outside the acute episode) <20 mL/min/1.73 m²
  • Renal replacement therapy
  • Metabolic or respiratory acidosis (arterial pH <7.35)
  • Sodium bicarbonate administration before inclusion

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Non randomizzato
  • Modello interventistico: Assegnazione sequenziale
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Comparatore attivo: Loop diuretic alone (LD)

Intravenous furosemide. Initial dose: twice the oral outpatient dose (maximum 160 mg IV), or 40 mg IV in patients not on chronic loop diuretics. Subsequent dose adjustments at the attending physician's discretion.

Intravenous furosemide; initial dose twice the oral outpatient dose (max 160 mg) or 40 mg if loop diuretic-naïve; subsequent adjustments per attending physician.

Sperimentale: Loop diuretic + SGLT2 inhibitor (LD+SGLT2i)

Intravenous furosemide (as in the LD arm) plus oral dapagliflozin 10 mg or empagliflozin 10 mg once daily, started on day 1. SGLT2i may be continued after day 3.

Intravenous furosemide; initial dose twice the oral outpatient dose (max 160 mg) or 40 mg if loop diuretic-naïve; subsequent adjustments per attending physician.

Oral dapagliflozin 10 mg once daily.

Oral empagliflozin 10 mg once daily.

Sperimentale: Loop diuretic + acetazolamide (LD+A)

Intravenous furosemide (as in the LD arm) plus intravenous acetazolamide 500 mg once daily for a maximum of 3 days (maximum 3 administrations).

Intravenous furosemide; initial dose twice the oral outpatient dose (max 160 mg) or 40 mg if loop diuretic-naïve; subsequent adjustments per attending physician.

Intravenous acetazolamide 500 mg once daily for up to 3 days.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change in spot urinary sodium concentration at 6 hours
Lasso di tempo: Baseline and 6 hours after the first study treatment administration (day 1)

Change in spot urinary sodium concentration (mmol/L) from baseline to 6 hours after the first study treatment administration. The main comparison is LD+A versus LD alone; the comparison of LD+SGLT2i versus LD alone is secondary.

Baseline and 6 hours after the first study treatment administration (day 1)

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change in spot urinary sodium concentration at day 3
Lasso di tempo: Baseline and 6 hours after the third study treatment administration (day 3)

Change in spot urinary sodium (mmol/L) from baseline to 6 hours after the third study treatment administration.

Baseline and 6 hours after the third study treatment administration (day 3)
Proportion of patients with spot urinary sodium >70 mmol/L
Lasso di tempo: 6 hours after first administration (day 1)

Percentage of patients achieving spot urinary sodium >70 mmol/L 6 hours after the first study treatment administration.

6 hours after first administration (day 1)
Change in spot urinary potassium
Lasso di tempo: Baseline, 6 hours after first administration (day 1) and 6 hours after third administration (day 3)

Change in spot urinary potassium (mmol/L) from baseline.

Baseline, 6 hours after first administration (day 1) and 6 hours after third administration (day 3)
Change in spot urinary magnesium
Lasso di tempo: Baseline, 6 hours after first administration (day 1) and 6 hours after third administration (day 3)

Change in spot urinary magnesium from baseline.

Baseline, 6 hours after first administration (day 1) and 6 hours after third administration (day 3)
Change in spot urinary phosphate
Lasso di tempo: Baseline, 6 hours after first administration (day 1) and 6 hours after third administration (day 3)

Change in spot urinary phosphate from baseline.

Baseline, 6 hours after first administration (day 1) and 6 hours after third administration (day 3)
Change in estimated glomerular filtration rate (eGFR)
Lasso di tempo: Baseline and day 3

Change in eGFR (mL/min/1.73 m²) from baseline.

Baseline and day 3
Change in hemoglobin
Lasso di tempo: Baseline and day 3

Change in hemoglobin (g/dL) from baseline.

Baseline and day 3
Change in hematocrit
Lasso di tempo: Baseline and day 3

Change in hematocrit (%) from baseline.

Baseline and day 3
Change in serum urea
Lasso di tempo: Baseline and day 3

Change in serum urea (mg/dL) from baseline.

Baseline and day 3
Change in serum sodium
Lasso di tempo: Baseline and day 3

Change in serum sodium (mmol/L) from baseline.

Baseline and day 3
Change in serum potassium
Lasso di tempo: Baseline and day 3

Change in serum potassium (mmol/L) from baseline.

Baseline and day 3
Change in serum chloride
Lasso di tempo: Baseline and day 3

Change in serum chloride (mmol/L) from baseline.

Baseline and day 3
Change in systolic blood pressure
Lasso di tempo: Baseline, day 2 and day 3

Change in systolic blood pressure (mmHg) from baseline.

Baseline, day 2 and day 3
Change in diastolic blood pressure
Lasso di tempo: Baseline, day 2 and day 3

Change in diastolic blood pressure (mmHg) from baseline.

Baseline, day 2 and day 3
Change in clinical congestion score
Lasso di tempo: Baseline, day 2 and day 3

Change in the clinical congestion score from baseline. The clinical congestion score is a composite score based on three items (orthopnea, peripheral edema and jugular venous pressure elevation), each graded from 0 to 3, with a total score ranging from 0 (no congestion) to 9 (maximum congestion). Higher scores indicate a worse outcome (more congestion).

Baseline, day 2 and day 3
Proportion of patients with clinical decongestion
Lasso di tempo: Day 3

Percentage of patients achieving clinical decongestion, defined as a clinical congestion score ≤2 points. The clinical congestion score is a composite score based on orthopnea, peripheral edema and jugular venous pressure elevation, each graded from 0 to 3 (total score 0-9; higher scores indicate more congestion).

Day 3
Cumulative intravenous loop diuretic dose
Lasso di tempo: Up to day 3

Cumulative intravenous furosemide dose (mg) administered up to day 3.

Up to day 3
Incidence of hypokalemia
Lasso di tempo: Baseline to day 3

Percentage of patients with serum potassium <3.5 mmol/L.

Baseline to day 3
Incidence of severe hypokalemia
Lasso di tempo: Baseline to day 3

Percentage of patients with serum potassium <3.0 mmol/L.

Baseline to day 3
Incidence of hyponatremia
Lasso di tempo: Baseline to day 3

Percentage of patients with serum sodium <135 mmol/L.

Baseline to day 3
Incidence of hypotension
Lasso di tempo: Baseline to day 3

Percentage of patients with systolic blood pressure <90 mmHg.

Baseline to day 3
Incidence of stage 2 acute kidney injury
Lasso di tempo: Baseline to day 3

Percentage of patients with stage 2 acute kidney injury according to the Kidney Disease: Improving Global Outcomes (KDIGO) staging criteria, defined as at least doubling of serum creatinine from baseline. KDIGO stages range from 1 to 3, with higher stages indicating more severe kidney injury (worse outcome).

Baseline to day 3
Incidence of ≥50% increase in serum creatinine
Lasso di tempo: Baseline to day 3

Percentage of patients with ≥50% increase in serum creatinine from baseline.

Baseline to day 3

Altre misure di risultato

Misura del risultato
Misura Descrizione
Lasso di tempo
Length of hospital stay
Lasso di tempo: From emergency department admission until hospital discharge, assessed up to 90 days

Duration of index hospitalization (days).

From emergency department admission until hospital discharge, assessed up to 90 days
In-hospital mortality
Lasso di tempo: From emergency department admission until hospital discharge, assessed up to 90 days

Death from any cause during index hospitalization.

From emergency department admission until hospital discharge, assessed up to 90 days
All-cause mortality
Lasso di tempo: From study inclusion until death from any cause, assessed up to 90 days

Time to death from any cause.

From study inclusion until death from any cause, assessed up to 90 days
Cardiovascular mortality
Lasso di tempo: From study inclusion until cardiovascular death, assessed up to 90 days

Time to cardiovascular death.

From study inclusion until cardiovascular death, assessed up to 90 days
All-cause rehospitalization
Lasso di tempo: From hospital discharge until first rehospitalization for any cause, assessed up to 90 days after study inclusion

Time to first rehospitalization for any cause.

From hospital discharge until first rehospitalization for any cause, assessed up to 90 days after study inclusion
Heart failure rehospitalization
Lasso di tempo: From hospital discharge until first rehospitalization for heart failure, assessed up to 90 days after study inclusion

Time to first rehospitalization for heart failure.

From hospital discharge until first rehospitalization for heart failure, assessed up to 90 days after study inclusion
Composite of all-cause mortality or all-cause rehospitalization
Lasso di tempo: From study inclusion until the first occurrence of any component event, assessed up to 90 days

Time to first occurrence of all-cause death or all-cause rehospitalization.

From study inclusion until the first occurrence of any component event, assessed up to 90 days
Composite of cardiovascular mortality or heart failure rehospitalization
Lasso di tempo: From study inclusion until the first occurrence of any component event, assessed up to 90 days

Time to first occurrence of cardiovascular death or heart failure rehospitalization.

From study inclusion until the first occurrence of any component event, assessed up to 90 days

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Investigatori

  • Investigatore principale: Pedro M. Marques, MD, Unidade Local de Saúde São João, Oporto

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

11 marzo 2024

Completamento primario (Effettivo)

29 settembre 2026

Completamento dello studio (Stimato)

1 dicembre 2026

Date di iscrizione allo studio

Primo inviato

29 ottobre 2026

Primo inviato che soddisfa i criteri di controllo qualità

5 novembre 2026

Primo Inserito (Effettivo)

9 novembre 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

9 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

5 novembre 2026

Ultimo verificato

1 ottobre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • GLIDE-DHF

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .