ClinicalTrials.gg
RecruitingNCT06642272APPLE TREEUpdated Sep 18, 2026

A Pragmatic Trial Comparing Empagliflozin and Dapagliflozin Through Cluster Randomization Embedded in the Electronic Health Record

A Phase 4 interventional study of Empagliflozin 10 MG and Dapagliflozin 10 MG in Diabetes Mellitus, Type 2, Heart Failure and Chronic Kidney Diseases, sponsored by Herlev and Gentofte Hospital. Recruiting at 12 sites in Denmark. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-18.

Sponsored by Herlev and Gentofte Hospital · Phase 4, Interventional, and Treatment

From the registry’s dates

  • Started Oct 2024; still recruiting 2 years 1 month later.
Phase
Phase 4
Study type
Interventional
Enrollment
17,200
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The aim of this clinical trial is investigate the comparative effectiveness of empagliflozin and dapagliflozin for the treatment of diabetes, chronic kidney disease, and heart failure.

Patients who are prescribed either empagliflozin or dapagliflozin, as part of daily clinical practice at the participating sites, will be included in the study. Treatment will be randomized automatically through the electronic health record software in clusters defined by time of day.

https://www.appletreestudy.com

02

Conditions studied

  • Diabetes Mellitus, Type 2
  • Heart Failure
  • Chronic Kidney Diseases
03

In context

Diabetes Mellitus, Type 2

10,371 studies on the registry are indexed under Diabetes Mellitus, Type 2; 1,406 are open to participants now.

This study's planned enrollment of 17,200 is above the median of 80 across 8,350 interventional studies indexed under Diabetes Mellitus, Type 2.

Browse Diabetes Mellitus, Type 2 studies →

Lead sponsor

Herlev and Gentofte Hospital is the lead sponsor of 75 studies on the registry; 25 are open to participants now.

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

04

Who can participate

Ages eligible
18 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

  • Adults aged 18 years or more

Exclusion criteria

Exclusion Criteria:

  • Incapabability of giving
  • Withdrawal of informed consent
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
17,200 participants (estimated)

Study arms

  • Other
    Empagliflozin 10 MG

    Head-to-head comparator

    Drug: Empagliflozin 10 MG

  • Other
    Dapagliflozin 10 MG

    Head-to-head comparator

    Drug: Dapagliflozin 10 MG

Interventions

06

What researchers measure

Primary outcomes

  1. Time to the first occurrence of any of the components of the composite: all-cause mortality, hospitalization for heart failure, hospitalization for myocardial infarction, hospitalization for ischemic stroke, and incident or worsening nephropathy.

    Incident or worsening nephropathy is defined as: * A sustained decrease in estimated glomerular filtration rate (eGFR) of ≥40% from baseline * A sustained decrease in eGFR of ≤10 per minute per 1.73 m2 * Initiation of dialysis * Kidney transplantation

    Time frame: Up to 24 months

Secondary outcomes

  1. All-cause mortality

    Time frame: Up to 24 months

  2. Hospitalization for heart failure

    Time frame: Up to 24 months

  3. Hospitalization for myocardial infarction

    Time frame: Up to 24 months

  4. Hospitalization for ischemic stroke

    Time frame: Up to 24 months

  5. Incident or worsening nephropathy

    Defined as a sustained decrease in estimated glomerular filtration rate (eGFR) of ≥40% from baseline, a sustained decrease in eGFR of ≤10 per minute per 1.73 m2, initiation of dialysis, or kidney transplantation

    Time frame: Up to 24 months

  6. Hospitalization for coronary revascularization

    Time frame: Up to 24 months

  7. Hospitalization for unstable angina

    Time frame: Up to 24 months

Other outcomes

  1. Hospitalization for ketoacidosis

    Safety outcome

    Time frame: Up to 24 months

  2. Hospitalization for limb amputation

    Safety outcome

    Time frame: Up to 24 months

  3. Hospitalization for genitourinary infection

    Safety outcome

    Time frame: Up to 24 months

  4. Hospitalization for fracture

    Safety outcome

    Time frame: Up to 24 months

07

Study locations

12 of 12 sites recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 18, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06642272
Lead sponsor
Herlev and Gentofte Hospital
Responsible party
Daniel Mølager Christensen (Investigator, Herlev and Gentofte Hospital) — Principal investigator
First posted
Oct 15, 2024
Start date
Oct 10, 2024
Primary completion
Dec 31, 2028 (estimated)
Completion
Dec 31, 2028 (estimated)
Last update
Sep 18, 2026

Study contacts

Morten Schou, Professor
Contact
morten.schou.04@regionh.dk
004540523920
Daniel M. Christensen, MD, PhD
Contact
dmc@dadlnet.dk
004526248546

Oversight

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

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Studies of the drugs tested here: Empagliflozin · Dapagliflozin

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