Digoxin Evaluation in Chronic Heart Failure: Investigational Study In Outpatients in the Netherlands

NCT ID: NCT03783429

Last Updated: 2023-12-12

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

982 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-01

Study Completion Date

2025-07-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Digoxin is the oldest, market-authorized drug for heart failure (HF), and very cheap. A large trial with digoxin, the DIG trial, executed in the early nineties revealed a highly significant reduction in HF hospitalizations, but no effect on mortality. A post-hoc analysis of the DIG trial suggests that low serum concentrations of digoxin may not only improve HF hospitalizations but also mortality in chronic HF patients. To confirm these retrospective analyses, a prospective, randomized, placebo-controlled trial is necessary to establish the position of digoxin in the contemporary treatment of HF. Therefore, the investigators examine whether low-level, aiming for serum concentrations 0.5-0.9ng/mL, digoxin is beneficial in HF patients with reduced or mid-range ejection fractions (LVEF \<50%).

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Heart Failure

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Heart Failure Digoxin Atrial fibrillation

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A national, multicenter, randomized, double-blind placebo controlled, clinical trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Double blind, placebo controlled

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Intervention group

The intervention group will receive low-dose digoxin

Group Type ACTIVE_COMPARATOR

Digoxin

Intervention Type DRUG

Digoxin tablets will be given orally

Placebo group

The placebo group will receive a matching placebo

Group Type PLACEBO_COMPARATOR

Placebos

Intervention Type DRUG

Placebo tablets will be given orally

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Digoxin

Digoxin tablets will be given orally

Intervention Type DRUG

Placebos

Placebo tablets will be given orally

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Age ≥18year
2. Outpatients with chronic HF, New York Heart Association \[NYHA\] class II - ambulatory IV
3. LVEF\<50%
4. Serum NT-proBNP concentrations:

Previous HF hospitalization ≤ 1 year before randomisation ≥400pg/mL if sinus rhythm; ≥800pg/mL if AF Previous HF hospitalization \> 1 year before randomisation or in the absence of HF hospitalizations ≥ 600pg/mL if sinus rhythm; ≥1000 pg/mL if AF

BNP concentrations:

Previous HF hospitalization ≤ 1 year before randomisation ≥100pg/mL if sinus rhythm; ≥200pg/mL if AF Previous HF hospitalization \> 1 year before randomisation or in absence of HF hospitalization ≥150pg/mL if sinus rhythm; ≥250pg/mL if AF.
5. ≥14 days stable on guideline-recommended therapy (doses and number of therapies as tolerated by each patient)

Exclusion Criteria

1. Heart rate ≤60bpm (if sinus rhythm); heart rate ≤70bpm (if AF)
2. History of HF hospitalization ≤7days
3. History of myocardial infarction, myocarditis, percutaneous intervention, RCT, pacemaker/ICD implantation, cardiac surgery or stroke ≤30 days
4. Estimated glomerular filtration rate (eGFR), ≤30ml/min/1.73m2
5. The presence of a mechanical assist device
6. Use of inotropic drugs (dopamine, dobutamine, (nor)adrenaline, and milrinon)
7. Scheduled for mechanical assist device or heart transplant
8. Other non-cardiac conditions with limited life expectancy (≤ duration of the study)
9. Amyloid, hypertrophic obstructive or constrictive cardiomyopathy
10. Accessory atrio-ventricular pathway (e.g. Wolf-Parkinson-White syndrome)
11. (Intermittent) complete heart block or second-degree AV block type Mobitz without pace maker or ICD
12. Severe (grade III/III) aortic valve disease
13. Complex congenital heart disease
14. Proven hypersensitivity to digoxin (prior side effects)
15. Concomitant medication that interacts with digoxin
16. Use of digoxin ≤6 months prior to inclusion
17. Participation in another (intervention) clinical trial (registry studies not included)
18. Women who are pregnant, breastfeeding or may be considering pregnancy during the study period
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Disphar International B.V.

INDUSTRY

Sponsor Role collaborator

Teva Nederland BV

UNKNOWN

Sponsor Role collaborator

Tiofarma BV

UNKNOWN

Sponsor Role collaborator

Netherlands Heart Foundation

OTHER

Sponsor Role collaborator

Werkgroep Cardiologische centra Nederland

UNKNOWN

Sponsor Role collaborator

University Medical Center Groningen

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

M. Rienstra

Prof. Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Michiel Rienstra, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Medical Center Groningen

Peter van der Meer, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Medical Center Groningen

Dirk J van Veldhuisen, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Medical Center Groningen

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Noordwest Ziekenhuisgroep

Alkmaar, , Netherlands

Site Status

Zorggroep Twente

Almelo, , Netherlands

Site Status

Meander Medisch Centrum

Amersfoort, , Netherlands

Site Status

BovenIJ Ziekenhuis

Amsterdam, , Netherlands

Site Status

Gelre Ziekenhuizen

Apeldoorn, , Netherlands

Site Status

Rijnstate Ziekenhuis

Arnhem, , Netherlands

Site Status

Rode Kruis Ziekenhuis

Beverwijk, , Netherlands

Site Status

Tergooi

Blaricum, , Netherlands

Site Status

Amphia Ziekenhuis

Breda, , Netherlands

Site Status

Ijsselland Ziekenhuis

Capelle aan den IJssel, , Netherlands

Site Status

Reinier de Graaf Gasthuis

Delft, , Netherlands

Site Status

Deventer Ziekenhuis

Deventer, , Netherlands

Site Status

Van Weel Bethesda

Dirksland, , Netherlands

Site Status

Slingeland Ziekenhuis

Doetinchem, , Netherlands

Site Status

Ziekenhuis Gelderse Vallei

Ede, , Netherlands

Site Status

Scheper Ziekenhuis

Emmen, , Netherlands

Site Status

Admiraal de Ruyter Ziekenhuis

Goes, , Netherlands

Site Status

Beatrix Ziekenhuis

Gorinchem, , Netherlands

Site Status

Groene Hart Ziekenhuis

Gouda, , Netherlands

Site Status

Martini Ziekenhuis

Groningen, , Netherlands

Site Status

University Medical Center Groningen

Groningen, , Netherlands

Site Status

Spaarne Gasthuis

Haarlem, , Netherlands

Site Status

Saxenburgh MC

Hardenberg, , Netherlands

Site Status

Ziekenhuis St Jansdal

Harderwijk, , Netherlands

Site Status

Zuyderland Medisch Centrum

Heerlen, , Netherlands

Site Status

Elkerliek Ziekenhuis

Helmond, , Netherlands

Site Status

Bethesda

Hoogeveen, , Netherlands

Site Status

Medisch Centrum Leeuwarden

Leeuwarden, , Netherlands

Site Status

Alrijne Ziekenhuis

Leiden, , Netherlands

Site Status

Maastricht UMC+

Maastricht, , Netherlands

Site Status

Isala Diaconessenhuis

Meppel, , Netherlands

Site Status

Radboud University Medical Center

Nijmegen, , Netherlands

Site Status

Bravis ziekenhuis

Roosendaal, , Netherlands

Site Status

Erasmus Medisch Centrum

Rotterdam, , Netherlands

Site Status

Franciscus Gasthuis

Rotterdam, , Netherlands

Site Status

Ikazia Ziekenhuis

Rotterdam, , Netherlands

Site Status

Franciscus Vlietland

Schiedam, , Netherlands

Site Status

Antonius Ziekenhuis Sneek

Sneek, , Netherlands

Site Status

Refaja

Stadskanaal, , Netherlands

Site Status

Haaglanden Medisch Centrum

The Hague, , Netherlands

Site Status

Elisabeth-Tweesteden Ziekenhuis

Tilburg, , Netherlands

Site Status

Diak. Utrecht

Utrecht, , Netherlands

Site Status

Máxima Medisch Centrum

Veldhoven, , Netherlands

Site Status

Zaans Medisch Centrum

Zaandam, , Netherlands

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Netherlands

References

Explore related publications, articles, or registry entries linked to this study.

van Veldhuisen DJ, Rienstra M, Mosterd A, Alings AM, van Asselt ADJ, Bouvy ML, Tijssen JGP, Schaap J, van der Wall EE, Voors AA, Boorsma EM, Lok DJA, Crijns HJGM, Schut A, Vijver MAT, Voordes GHD, de Vos AH, Maas-Soer EL, Smit NW, Touw DJ, Samuel M, van der Meer P; DECISION Investigators and Committees. Efficacy and safety of low-dose digoxin in patients with heart failure. Rationale and design of the DECISION trial. Eur J Heart Fail. 2024 Oct;26(10):2223-2230. doi: 10.1002/ejhf.3428. Epub 2024 Aug 30.

Reference Type DERIVED
PMID: 39212246 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

DECISION trial

Identifier Type: -

Identifier Source: org_study_id