ClinicalTrials.gg
RecruitingNCT06249945EMPA-PREDUpdated Dec 16, 2024

EMPAgliflozin in Heart Failure With PReserved Ejection Fraction and End Stage Renal Disease

A Phase 4 interventional study of Empagliflozin 25 MG and Placebo in Heart Failure With Preserved Ejection Fraction and End Stage Renal Disease on Dialysis, sponsored by National Taiwan University Hospital. Recruiting at 2 sites in Taiwan. Open to participants aged 20 Years and older. Per ClinicalTrials.gov, last updated 2024-12-16.

Sponsored by National Taiwan University Hospital · Phase 4, Interventional, and Treatment

From the registry’s dates

  • Started Mar 2024; still recruiting 2 years 7 months later.
Phase
Phase 4
Study type
Interventional
Enrollment
150
Allocation
Randomized
Ages
20 Years and older
Sex
All
01

Study summary

The presence of CKD has been linked to the development of HFpEF. Currently, the treatment for HFpEF is limited. SGLT2i are one of the few drug classes that have proven efficacy in HFpEF in randomized controlled trials. The results of mechanistic studies suggest that the benefits of SGLT2i on diastolic heart failure are independent of their glycosuric actions and may still be present in anuric subjects. Despite the significance of HFpEF in patients with CKD, patients with advanced kidney disease have been excluded from studies investigating anti-heart failure drugs. The effects of SGLT2i in patients under maintenance dialysis are largely unknown. Past pharmacokinetics and pharmacodynamics studies on empagliflozin in patients with end-stage renal disease (ESRD) demonstrated that the use of empagliflozin in patients with ESRD seemed safe, yet its efficacy remains to be explored.

02

Conditions studied

  • Heart Failure With Preserved Ejection Fraction
  • End Stage Renal Disease on Dialysis

Keywords

  • end-stage renal disease
  • sodium-glucose co-transporter 2 inhibitors
  • heart failure
  • diastolic function
  • empagliflozin
03

In context

Kidney Failure, Chronic

2,121 studies on the registry are indexed under Kidney Failure, Chronic; 264 are open to participants now.

This study's planned enrollment of 150 is above the median of 55 across 1,582 interventional studies indexed under Kidney Failure, Chronic.

Browse Kidney Failure, Chronic studies →

Lead sponsor

National Taiwan University Hospital is the lead sponsor of 2,608 studies on the registry; 573 are open to participants now.

Of its 11 completed or terminated interventional studies of FDA-regulated products, 2 (18%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
20 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age ≥20 years old
  • ESRD under chronic, maintenance dialysis with stable dry weight for the past 6 months
  • Prior diagnosis of HFpEF, as defined by a score of ≥5 on the HFA-PEFF diagnostic algorithm.

Exclusion criteria

Exclusion Criteria:

  • Age \<20 years old
  • Ongoing pregnancy
  • NYHA class IV heart failure
  • Any hospitalization for heart failure within the past month Ongoing acute urinary tract infection at the time of screening
  • Known acute genital infection
  • Severe peripheral artery disease (Rutherford category 4-6)
  • Acute coronary syndrome, stroke or transient ischemic attack within the past month
  • Recent initiation of chronic maintenance hemodialysis within 6 months
  • Adjustment of dry weight with changes greater than 5% of body weight within the past month
  • Documented left ventricular ejection fraction =\<40% by any imaging modality within 1 month of screening
  • Refused informed consent
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
150 participants (estimated)

Study arms

  • Experimental
    empagliflozin

    Jardiance, 25 mg, QD, for 6 months

    Drug: Empagliflozin 25 MG

  • Placebo comparator
    Placebo

    QD, for 6 months

    Drug: Placebo

Interventions

  • The medication will be packed in a customized sealed jar and labeled on the exterior of the jar.

    Also known as: Jardiance 25 MG

  • DrugPlacebo

    The placebo tablet is manufactured by Prince Pharmaceutical Co., Ltd, a leading manufacturer of nutritional supplements with certifications including cGMP, GMP, ISO, and HACCP. The Prince Pharmaceutical also provides Original Equipment Manufacturing (OEM)/Original Design Manufacturing (ODM) services for a wide array of tablet shapes, and post-processing techniques such as film coating and sugar coating.

06

What researchers measure

Primary outcomes

  1. Mitral early (E) and late (A) diastolic filling velocity ratio (E/A)

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 24 weeks of treatment

Secondary outcomes

  1. LV end-systolic volume index

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  2. LV end-diastolic volume index

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  3. LA volume index

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  4. LV ejection fraction

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  5. Left ventricular mass index

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  6. Global longitudinal strain

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  7. LA strain

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  8. Mitral inflow deceleration time

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  9. Mitral inflow deceleration time LV relative wall thickness

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  10. Tricuspid regurgitation peak gradient (TRPG)

    As assessed by echocardiography, performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  11. NT-proBNP

    Blood tests obtained pre-dialysis session

    Time frame: 4 weeks, 12 weeks and 24 weeks of treatment

  12. HbA1c

    Blood tests obtained pre-dialysis session

    Time frame: 4 weeks, 12 weeks and 24 weeks of treatment

  13. Lipid profile

    Blood tests obtained pre-dialysis session

    Time frame: 4 weeks, 12 weeks and 24 weeks of treatment

  14. KCCQ-OS

    Performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  15. 6-minute walking distance

    Performed on non-dialysis day

    Time frame: 12 weeks and 24 weeks of treatment

  16. 3-minute heart rate variability

    During hemodialysis session

    Time frame: 12 weeks and 24 weeks of treatment

  17. Blood pressure

    Obtained pre-dialysis session

    Time frame: 12 weeks and 24 weeks of treatment

  18. Major adverse cardiovascular events (composite of CV death, myocardial infarction, stroke)

    By medical record confirmation and by interview

    Time frame: 24 weeks of treatment

  19. Lower extremity non-traumatic amputation or revascularization

    By medical record confirmation and by interview

    Time frame: 24 weeks of treatment

  20. All-cause mortality

    By medical record confirmation and by interview

    Time frame: 24 weeks of treatment

  21. Hospitalization for heart failure

    By medical record confirmation and by interview

    Time frame: 24 weeks of treatment

  22. Hypoglycemic events

    By medical record confirmation and by interview

    Time frame: 24 weeks of treatment

  23. Diabetic ketoacidosis

    By medical record confirmation and by interview

    Time frame: 24 weeks of treatment

  24. Urinary tract infection

    By medical record confirmation and by interview

    Time frame: 24 weeks of treatment

  25. Genital tract infection

    By medical record confirmation and by interview

    Time frame: 24 weeks of treatment

  26. Hypokalemia

    Blood tests obtained pre-dialysis session

    Time frame: 4 weeks, 12 weeks and 24 weeks of treatment

07

Study locations

2 of 2 sites recruiting
  • National Taiwan University Hospital Hsinchu Branch
    Hsinchu, 300, Taiwan
    • Chih-Cheng Wu, PhD · Contact · chihchengwumd@gmail.com · 03 532 6151
    • Chih-Cheng Wu, PhD · Principal investigator
    Recruiting
  • Shin Kong Wu Ho-Su Memorial Hospital
    Taipei, 111, Taiwan
    • Donna SH Lin, MD · Contact · donna.lin24@gmail.com · 0912902379
    • Donna SH Lin, MD · Principal investigator
    Recruiting
08

References and documents

Publications

  • GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020 Feb 29;395(10225):709-733. doi: 10.1016/S0140-6736(20)30045-3. Epub 2020 Feb 13. PubMed 32061315 ↗
  • Kalantar-Zadeh K, Jafar TH, Nitsch D, Neuen BL, Perkovic V. Chronic kidney disease. Lancet. 2021 Aug 28;398(10302):786-802. doi: 10.1016/S0140-6736(21)00519-5. Epub 2021 Jun 24. PubMed 34175022 ↗
  • Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J Am Coll Cardiol. 2008 Nov 4;52(19):1527-39. doi: 10.1016/j.jacc.2008.07.051. PubMed 19007588 ↗
  • Bansal N, Zelnick L, Bhat Z, Dobre M, He J, Lash J, Jaar B, Mehta R, Raj D, Rincon-Choles H, Saunders M, Schrauben S, Weir M, Wright J, Go AS; CRIC Study Investigators. Burden and Outcomes of Heart Failure Hospitalizations in Adults With Chronic Kidney Disease. J Am Coll Cardiol. 2019 Jun 4;73(21):2691-2700. doi: 10.1016/j.jacc.2019.02.071. PubMed 31146814 ↗
  • Kotecha D, Gill SK, Flather MD, Holmes J, Packer M, Rosano G, Bohm M, McMurray JJV, Wikstrand J, Anker SD, van Veldhuisen DJ, Manzano L, von Lueder TG, Rigby AS, Andersson B, Kjekshus J, Wedel H, Ruschitzka F, Cleland JGF, Damman K, Redon J, Coats AJS; Beta-Blockers in Heart Failure Collaborative Group. Impact of Renal Impairment on Beta-Blocker Efficacy in Patients With Heart Failure. J Am Coll Cardiol. 2019 Dec 10;74(23):2893-2904. doi: 10.1016/j.jacc.2019.09.059. PubMed 31806133 ↗
  • Ferro CJ, Mark PB, Kanbay M, Sarafidis P, Heine GH, Rossignol P, Massy ZA, Mallamaci F, Valdivielso JM, Malyszko J, Verhaar MC, Ekart R, Vanholder R, London G, Ortiz A, Zoccali C. Lipid management in patients with chronic kidney disease. Nat Rev Nephrol. 2018 Dec;14(12):727-749. doi: 10.1038/s41581-018-0072-9. PubMed 30361677 ↗
  • Shah KS, Fang JC. Is Heart Failure with Preserved Ejection Fraction a Kidney Disorder? Curr Hypertens Rep. 2019 Oct 10;21(11):86. doi: 10.1007/s11906-019-0993-0. PubMed 31599363 ↗
  • Ter Maaten JM, Damman K, Verhaar MC, Paulus WJ, Duncker DJ, Cheng C, van Heerebeek L, Hillege HL, Lam CS, Navis G, Voors AA. Connecting heart failure with preserved ejection fraction and renal dysfunction: the role of endothelial dysfunction and inflammation. Eur J Heart Fail. 2016 Jun;18(6):588-98. doi: 10.1002/ejhf.497. Epub 2016 Feb 10. PubMed 26861140 ↗
  • Cohen JB, Schrauben SJ, Zhao L, Basso MD, Cvijic ME, Li Z, Yarde M, Wang Z, Bhattacharya PT, Chirinos DA, Prenner S, Zamani P, Seiffert DA, Car BD, Gordon DA, Margulies K, Cappola T, Chirinos JA. Clinical Phenogroups in Heart Failure With Preserved Ejection Fraction: Detailed Phenotypes, Prognosis, and Response to Spironolactone. JACC Heart Fail. 2020 Mar;8(3):172-184. doi: 10.1016/j.jchf.2019.09.009. Epub 2020 Jan 8. PubMed 31926856 ↗
  • Anker SD, Butler J, Filippatos G, Ferreira JP, Bocchi E, Bohm M, Brunner-La Rocca HP, Choi DJ, Chopra V, Chuquiure-Valenzuela E, Giannetti N, Gomez-Mesa JE, Janssens S, Januzzi JL, Gonzalez-Juanatey JR, Merkely B, Nicholls SJ, Perrone SV, Pina IL, Ponikowski P, Senni M, Sim D, Spinar J, Squire I, Taddei S, Tsutsui H, Verma S, Vinereanu D, Zhang J, Carson P, Lam CSP, Marx N, Zeller C, Sattar N, Jamal W, Schnaidt S, Schnee JM, Brueckmann M, Pocock SJ, Zannad F, Packer M; EMPEROR-Preserved Trial Investigators. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021 Oct 14;385(16):1451-1461. doi: 10.1056/NEJMoa2107038. Epub 2021 Aug 27. PubMed 34449189 ↗
  • Verma S, Mazer CD, Yan AT, Mason T, Garg V, Teoh H, Zuo F, Quan A, Farkouh ME, Fitchett DH, Goodman SG, Goldenberg RM, Al-Omran M, Gilbert RE, Bhatt DL, Leiter LA, Juni P, Zinman B, Connelly KA. Effect of Empagliflozin on Left Ventricular Mass in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease: The EMPA-HEART CardioLink-6 Randomized Clinical Trial. Circulation. 2019 Nov 19;140(21):1693-1702. doi: 10.1161/CIRCULATIONAHA.119.042375. Epub 2019 Aug 22. PubMed 31434508 ↗
  • Ersboll M, Jurgens M, Hasbak P, Kjaer A, Wolsk E, Zerahn B, Brandt-Jacobsen NH, Gaede P, Rossing P, Faber J, Inzucchi SE, Gustafsson F, Schou M, Kistorp C. Effect of empagliflozin on myocardial structure and function in patients with type 2 diabetes at high cardiovascular risk: the SIMPLE randomized clinical trial. Int J Cardiovasc Imaging. 2022 Mar;38(3):579-587. doi: 10.1007/s10554-021-02443-5. Epub 2021 Oct 20. PubMed 34669059 ↗
  • Soga F, Tanaka H, Tatsumi K, Mochizuki Y, Sano H, Toki H, Matsumoto K, Shite J, Takaoka H, Doi T, Hirata KI. Impact of Dapagliflozin on the Left Ventricular Diastolic Function in Diabetic Patients with Heart Failure Complicating Cardiovascular Risk Factors. Intern Med. 2021;60(15):2367-2374. doi: 10.2169/internalmedicine.6127-20. Epub 2021 Aug 1. PubMed 34334588 ↗
  • Li X, Lu Q, Qiu Y, do Carmo JM, Wang Z, da Silva AA, Mouton A, Omoto ACM, Hall ME, Li J, Hall JE. Direct Cardiac Actions of the Sodium Glucose Co-Transporter 2 Inhibitor Empagliflozin Improve Myocardial Oxidative Phosphorylation and Attenuate Pressure-Overload Heart Failure. J Am Heart Assoc. 2021 Mar 16;10(6):e018298. doi: 10.1161/JAHA.120.018298. Epub 2021 Mar 13. PubMed 33719499 ↗
  • Pabel S, Wagner S, Bollenberg H, Bengel P, Kovacs A, Schach C, Tirilomis P, Mustroph J, Renner A, Gummert J, Fischer T, Van Linthout S, Tschope C, Streckfuss-Bomeke K, Hasenfuss G, Maier LS, Hamdani N, Sossalla S. Empagliflozin directly improves diastolic function in human heart failure. Eur J Heart Fail. 2018 Dec;20(12):1690-1700. doi: 10.1002/ejhf.1328. Epub 2018 Oct 17. PubMed 30328645 ↗
  • Macha S, Mattheus M, Halabi A, Pinnetti S, Woerle HJ, Broedl UC. Pharmacokinetics, pharmacodynamics and safety of empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, in subjects with renal impairment. Diabetes Obes Metab. 2014 Mar;16(3):215-22. doi: 10.1111/dom.12182. Epub 2013 Aug 19. PubMed 23859488 ↗
  • Pieske B, Tschope C, de Boer RA, Fraser AG, Anker SD, Donal E, Edelmann F, Fu M, Guazzi M, Lam CSP, Lancellotti P, Melenovsky V, Morris DA, Nagel E, Pieske-Kraigher E, Ponikowski P, Solomon SD, Vasan RS, Rutten FH, Voors AA, Ruschitzka F, Paulus WJ, Seferovic P, Filippatos G. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J. 2019 Oct 21;40(40):3297-3317. doi: 10.1093/eurheartj/ehz641. PubMed 31504452 ↗
  • Rau M, Thiele K, Hartmann NK, Schuh A, Altiok E, Mollmann J, Keszei AP, Bohm M, Marx N, Lehrke M. Empagliflozin does not change cardiac index nor systemic vascular resistance but rapidly improves left ventricular filling pressure in patients with type 2 diabetes: a randomized controlled study. Cardiovasc Diabetol. 2021 Jan 7;20(1):6. doi: 10.1186/s12933-020-01175-5. PubMed 33413355 ↗
  • Shim CY, Seo J, Cho I, Lee CJ, Cho IJ, Lhagvasuren P, Kang SM, Ha JW, Han G, Jang Y, Hong GR. Randomized, Controlled Trial to Evaluate the Effect of Dapagliflozin on Left Ventricular Diastolic Function in Patients With Type 2 Diabetes Mellitus: The IDDIA Trial. Circulation. 2021 Feb 2;143(5):510-512. doi: 10.1161/CIRCULATIONAHA.120.051992. Epub 2020 Nov 13. No abstract available. PubMed 33186508 ↗
  • Junger C, Prochaska JH, Gori T, Schulz A, Binder H, Daiber A, Koeck T, Rapp S, Lackner KJ, Munzel T, Wild PS. Rationale and design of the effects of EMpagliflozin on left ventricular DIAstolic function in diabetes (EmDia) study. J Cardiovasc Med (Hagerstown). 2022 Mar 1;23(3):191-197. doi: 10.2459/JCM.0000000000001267. PubMed 34939776 ↗
  • Jurgens M, Schou M, Hasbak P, Kjaer A, Wolsk E, Zerahn B, Wiberg M, Brandt NH, Gaede PH, Rossing P, Faber J, Inzucchi S, Gustafsson F, Kistorp CM. Design of a randomised controlled trial of the effects of empagliflozin on myocardial perfusion, function and metabolism in type 2 diabetes patients at high cardiovascular risk (the SIMPLE trial). BMJ Open. 2019 Nov 27;9(11):e029098. doi: 10.1136/bmjopen-2019-029098. PubMed 31780586 ↗
  • Lin DS, Lo HY, Yang CW, Wu CC. Safety and Short-Term Effects of Empagliflozin in Patients with Heart Failure and End-Stage Renal Disease. Am J Cardiovasc Drugs. 2026 Jan;26(1):83-96. doi: 10.1007/s40256-025-00760-x. Epub 2025 Aug 25. PubMed 40855136 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 16, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06249945
Collaborators
Shin Kong Wu Ho-Su Memorial Hospital
Responsible party
Sponsor
First posted
Feb 8, 2024
Start date
Mar 5, 2024
Primary completion
Dec 31, 2027 (estimated)
Completion
Dec 31, 2030 (estimated)
Last update
Dec 16, 2024

Study contacts

Donna SH Lin, MD
Contact
Donna.lin24@gmail.com
+886912902379
Hao-Yun Lo, MD
Contact
limoonby@gmail.com
+886972234640
Donna SH Lin, MD
principal investigator · Shin Kong Wu Ho-Su Memorial Hospital
Chih-Cheng Wu, MD. PhD
principal investigator · National Taiwan University Hsin-Chu Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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