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

26 maggio 2026 aggiornato da: 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.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

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.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

160

Fase

  • Fase 2

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

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

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

  • Adulto
  • Adulto più anziano

Accetta volontari sani

No

Descrizione

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).
  • Patient is 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.

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: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Separare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: 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).
Droga: 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.
Droga: Dapagliflozin (10mg Tab)
Sodium-glucose cotransporter 2 (SGLT2) inhibitor administered orally at a stable, standard-of-care dose of 10 mg once daily.
Comparatore attivo: Monotherapy Control Arm
Patients continue to receive standard-of-care dapagliflozin monotherapy (10 mg once daily).
Droga: Dapagliflozin (10mg Tab)
Sodium-glucose cotransporter 2 (SGLT2) inhibitor administered orally at a stable, standard-of-care dose of 10 mg once daily.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change from Baseline in Left Ventricular Global Longitudinal Strain (LV-GLS) assessed by echocardiography
Lasso di tempo: 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

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels.
Lasso di tempo: 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).
Lasso di tempo: 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.
Lasso di tempo: 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
Lasso di tempo: 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

Collaboratori e investigatori

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

Sponsor

Kafrelsheikh University

Investigatori

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

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)

2 giugno 2025

Completamento primario (Effettivo)

29 aprile 2026

Completamento dello studio (Effettivo)

29 aprile 2026

Date di iscrizione allo studio

Primo inviato

20 maggio 2026

Primo inviato che soddisfa i criteri di controllo qualità

20 maggio 2026

Primo Inserito (Effettivo)

27 maggio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

29 maggio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

26 maggio 2026

Ultimo verificato

1 maggio 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • KFSIRB200-648

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

SÌ

Descrizione del piano IPD

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.

Periodo di condivisione IPD

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

Criteri di accesso alla condivisione IPD

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.

Tipo di informazioni di supporto alla condivisione IPD

  • STUDIO_PROTOCOLLO
  • LINFA

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 .

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