Effects of the SGLT2-inhibitor Empagliflozin on Patients With Chronic SIADH - the SANDx Study

NCT ID: NCT03202667

Last Updated: 2021-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

17 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-15

Study Completion Date

2021-12-06

Brief Summary

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Syndrome of inappropriate antidiuresis (SIADH) is characterized by an imbalance of antidiuretic vasopressin (AVP) secretion. The impaired AVP regulation leads to water retention and secondary natriuresis and is a common cause for hyponatremia.

Especially chronic (\>72h) SIADH is difficult to treat as standard therapeutic options (water restriction, urea, salt tablets) often do not succeed in correction of hyponatremia, making additional therapy necessary.

Empagliflozin is a sodium glucose co-transporter 2 (SGLT2)-inhibitor, which is a well-tolerated treatment option for type 2 diabetes mellitus. The inhibition of SGLT2 in the proximal tubule leads to renal excretion of glucose with subsequent osmotic diuresis. This mechanism could result in a therapeutic effect in patients with chronic SIADH, as it resembles the aquaretic effect of urea.

The aim of this study is to evaluate whether empagliflozin has an effect on the serum sodium levels of patients with chronic SIADH.

Detailed Description

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Conditions

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SIAD - Syndrome of Inappropriate Antidiuresis Hyponatremia

Keywords

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SGLT2-inhibitor Treatment

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Empagliflozin

Treatment with empagliflozin 25mg tablets once daily for 28 days

Group Type ACTIVE_COMPARATOR

Empagliflozin 25mg

Intervention Type DRUG

Treatment with empagliflozin 25mg once daily for 28 days

Placebo

Treatment with Placebo tablets once daily for 28 days

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Treatment with Placebo oral tablet once daily for 28 days

Interventions

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Empagliflozin 25mg

Treatment with empagliflozin 25mg once daily for 28 days

Intervention Type DRUG

Placebo

Treatment with Placebo oral tablet once daily for 28 days

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Adult patients (age ≥ 18 years) with hyponatremia (\<133mmol/l) due to chronic (\>72h) SIADH defined as

* serum osmolality \<275mosm/kg
* urine osmolality \>100mosm/kg
* urine sodium \>30mmol/l

Exclusion Criteria

* acute (\<72h) or transient hyponatremia
* severe symptomatic hyponatremia in need of hospital treatment
* diabetes mellitus type 1
* uncontrolled hypothyroidism
* uncontrolled adrenal insufficiency
* renal impairment (GFR \<45ml/min)
* cardiac failure
* symptomatic liver disease / severe hepatic impairment (ALAT / aspartate transaminase (ASAT) \> 3x upper limit)
* treatment with SGLT 2 inhibitors, lithium chloride, urea or glitazone
* severe immunosuppression
* pregnancy or breastfeeding
* palliative situation (end of life care)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Basel, Switzerland

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mirjam Christ-Crain, Prof. Dr. MD

Role: STUDY_DIRECTOR

University Hopsital Basel

Locations

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University Hospital Basel

Basel, , Switzerland

Site Status

Countries

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Switzerland

References

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Monnerat S, Refardt J, Potasso L, Meier C, Christ-Crain M. An Increase in Plasma Sodium Levels Is Associated With an Increase in Osteoblast Function in Chronic SIAD. J Clin Endocrinol Metab. 2023 Sep 18;108(10):e1027-e1033. doi: 10.1210/clinem/dgad238.

Reference Type DERIVED
PMID: 37098131 (View on PubMed)

Refardt J, Imber C, Nobbenhuis R, Sailer CO, Haslbauer A, Monnerat S, Bathelt C, Vogt DR, Berres M, Winzeler B, Bridenbaugh SA, Christ-Crain M. Treatment Effect of the SGLT2 Inhibitor Empagliflozin on Chronic Syndrome of Inappropriate Antidiuresis: Results of a Randomized, Double-Blind, Placebo-Controlled, Crossover Trial. J Am Soc Nephrol. 2023 Feb 1;34(2):322-332. doi: 10.1681/ASN.2022050623. Epub 2022 Nov 17.

Reference Type DERIVED
PMID: 36396331 (View on PubMed)

Other Identifiers

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2017-00701

Identifier Type: -

Identifier Source: org_study_id