Use of a Novel SUBCUTaneous Preparation of Furosemide to Facilitate Early Supported Discharge of Patients With Heart Failure

NCT ID: NCT05419115

Last Updated: 2025-04-15

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

170 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-17

Study Completion Date

2025-10-30

Brief Summary

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To investigate whether an early supported discharge strategy for patients admitted to hospital because of HF, using a pH neutral subcutaneous (SC) furosemide formulation (SQINFurosemide) at home (delivered by non-CE marked SQINInfusor), compared to a usual care strategy with intravenous (IV) furosemide in hospital, results in an increased number of days spent alive and out of hospital (DAOH) at 30 days.

Detailed Description

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HF is associated with frequent and lengthy hospitalisations. These hospitalisations are usually as a result of congestion, and the standard treatment of this is decongestion with intravenous (IV) diuretic (usually furosemide). This is usually delivered in a hospital setting. A new formulation of a pHneutral furosemide (SQIN-Furosemide) that can be delivered subcutaneously (SC) by a small patch pump (SQIN-Infusor) has been developed. Bioavailability of SQIN-Furosemide is similar to IV furosemide. This trial will test the efficacy and safety of novel SC furosemide 30mg/ml (SQIN-Furosemide), delivered in a home environment (compared to usual care strategy with IV furosemide delivered in secondary care) as part of a novel early supported discharge strategy in patients admitted to hospital with HF.

Conditions

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Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

randomised, parallel-group, active comparator controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Not possible

Study Groups

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Usual Care

Open label, 1:1 randomisation to usual care in hospital vs early supported discharge with SQIN-Furosemide administered via SQIN-Infusor.

Usual care: Usual care as per institutional practice (including IV diuretics)

Group Type NO_INTERVENTION

No interventions assigned to this group

Early supported discharge

Open label, 1:1 randomisation to usual care in hospital vs early supported discharge with SQIN-Furosemide administered via SQIN-Infusor.

Early supported discharge: with SQIN-Furosemide and SQIN-Infusor. SQIN-Furosemide: 80mg of SQIN-Furosemide in each cartridge; 5 hours running time; up to 2 applications in 24h (maximum dose of 160mg of SQIN-Furosemide in 24h). SQIN-Infusor: patient/carer administered.

Group Type EXPERIMENTAL

SQIN-Furosemide

Intervention Type DRUG

The investigational furosemide formulation (SQIN-Furosemide) is a Captisol®buffered solution of 80mg furosemide in 2.7 mL (30 mg/mL) at pH 7.4 (range: 7.0 to 7.8). SC infusion will be performed using the SQIN-Infusor which will deliver 2.7 mL of the SQIN-Furosemide formulation (80mg) over approximately 5 hours, using a biphasic delivery profile.

SQIN-Infusor

Intervention Type DEVICE

The investigational device (SQIN-Infusor) is an on-body delivery system that consists of a RU, DU, plus a charger (Figure 2). For the purpose of SUBCUT-HF II trial, the RU will be used for multiple infusions for a single participant. The DU will be used only once per infusion and disposed of. The RU must be charged after each use and will not restart for the next infusion without charging. Charging takes up to 15 minutes. SQIN-Infusor is a bespoke system, adapted from the design of a SC insulin pump. The RU consists of the drive-unit, the controllers, the rechargeable battery, and the user interface.

Interventions

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SQIN-Furosemide

The investigational furosemide formulation (SQIN-Furosemide) is a Captisol®buffered solution of 80mg furosemide in 2.7 mL (30 mg/mL) at pH 7.4 (range: 7.0 to 7.8). SC infusion will be performed using the SQIN-Infusor which will deliver 2.7 mL of the SQIN-Furosemide formulation (80mg) over approximately 5 hours, using a biphasic delivery profile.

Intervention Type DRUG

SQIN-Infusor

The investigational device (SQIN-Infusor) is an on-body delivery system that consists of a RU, DU, plus a charger (Figure 2). For the purpose of SUBCUT-HF II trial, the RU will be used for multiple infusions for a single participant. The DU will be used only once per infusion and disposed of. The RU must be charged after each use and will not restart for the next infusion without charging. Charging takes up to 15 minutes. SQIN-Infusor is a bespoke system, adapted from the design of a SC insulin pump. The RU consists of the drive-unit, the controllers, the rechargeable battery, and the user interface.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Written informed consent
* Male or female ≥18 years of age
* Meet European Society of Cardiology (ESC) criteria for diagnosis of HF1

* Elevated natriuretic peptide (BNP\> 100 pg/mL or NTproBNP \>300 pg/mL)
* Signs and symptoms of HF
* Echocardiographic structural or functional abnormality according to ESC guidelines
* Have received IV diuretic for treatment of HF within preceding 24 hours
* Be less than 96 hours after admission to hospital
* Requiring IV diuretics for a minimum of 24 hours after screening
* Have an echocardiogram or other assessment of cardiac structure and function within preceding 12 months or at screening
* Have a home environment that allows the patient to be able to mobilise within their residence and be able to pass urine into their toilet (unless catheterised)
* Able to operate (or has a caregiver who can operate) SQIN-Infusor (as assessed by training on a dummy device at screening)

Exclusion Criteria

* Unable to consent due to significant cognitive impairment or lack of capacity
* Unable to operate SQIN-Infusor (or no caregiver who is able to operate the device)
* Geographical reasons preventing follow-up visits
* Pregnancy or breast-feeding
* Requiring treatment with IV furosemide \>250 mg furosemide per day in the opinion of the treating physician
* Left sided valve disease with planned surgery or percutaneous intervention
* Type 1 myocardial infarction during index hospitalisation (participants with type 2 myocardial infarction can be included)2
* Renal impairment, defined as estimated glomerular filtration rate (eGFR) \< 20 mL/min/1.73 m 2 at screening
* Reasons (other than HF) which may prevent discharge from hospital, such as social circumstances or other significant medical condition (at investigator discretion)
* Women of childbearing potential
* Patient on active cardiac transplant waiting list
* Patient requiring on-going inotropic, vasopressor or intraaortic balloon pump support
* Potassium \<3.0 mmol/L
* Potassium \>6.0 mmol/L
* Sodium \<125 mmol/L
* Any surgical or medical condition which, in the opinion of the investigator, may pose an undue risk to the subject, interfere with participation in the study or which may affect the integrity of the data
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Glasgow

OTHER

Sponsor Role collaborator

NHS Greater Glasgow and Clyde

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mark Petrie, MBChB

Role: PRINCIPAL_INVESTIGATOR

University of Glasgow

Ross Campbell, MBChB

Role: PRINCIPAL_INVESTIGATOR

University of Glasgow

Locations

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Stoke Mandeville Hospital

Aylesbury, England, United Kingdom

Site Status RECRUITING

Basildon University Hospital

Basildon, England, United Kingdom

Site Status RECRUITING

Blackpool Victoria Hospital

Blackpool, England, United Kingdom

Site Status RECRUITING

University Hospitals Dorset

Bournemouth, England, United Kingdom

Site Status RECRUITING

Southmead Hospital

Bristol, England, United Kingdom

Site Status RECRUITING

University Hospital of North Tees

Hardwick, England, United Kingdom

Site Status RECRUITING

Wycombe General Hospital

High Wycombe, England, United Kingdom

Site Status RECRUITING

Leeds General Infirmary

Leeds, England, United Kingdom

Site Status RECRUITING

Glenfield Hospital

Leicester, England, United Kingdom

Site Status RECRUITING

St Thomas' Hospital

London, England, United Kingdom

Site Status RECRUITING

St. George's University of London

London, England, United Kingdom

Site Status RECRUITING

Manchester Heart Centre

Manchester, England, United Kingdom

Site Status RECRUITING

Queen Alexandra Hospital

Portsmouth, England, United Kingdom

Site Status RECRUITING

Sunderland Royal Hospital

Sunderland, England, United Kingdom

Site Status RECRUITING

University Hospital Ayr

Ayr, Scotland, United Kingdom

Site Status RECRUITING

Ninewells Hospital

Dundee, Scotland, United Kingdom

Site Status RECRUITING

Glasgow Royal Infirmary

Glasgow, Scotland, United Kingdom

Site Status RECRUITING

Forth Valley Hospital

Larbert, Scotland, United Kingdom

Site Status RECRUITING

Queen Elizabeth University Hospital

Glasgow, Strathclyde, United Kingdom

Site Status RECRUITING

University Hospital Monklands

Airdrie, , United Kingdom

Site Status RECRUITING

University Hospital Southampton

Southampton, , United Kingdom

Site Status RECRUITING

The Great Western Hospital

Swindon, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Mark Petrie, MBChB

Role: CONTACT

0141 330 2427

Ross Campbell, MBChB

Role: CONTACT

01413302418

Facility Contacts

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Christopher P Clifford

Role: primary

Henry Savage

Role: primary

Kenneth Wong

Role: primary

Chris Critoph

Role: primary

Chih Wong

Role: primary

Matthew Dewhurst

Role: primary

Christopher P Clifford

Role: primary

Kate Gatenby

Role: primary

Iain Squire

Role: primary

Rebekah Schiff

Role: primary

Robin Ray

Role: primary

Fozia Ahmed

Role: primary

Kaushik Guha

Role: primary

Samuel McClure

Role: primary

Ewan McKay

Role: primary

Ify Mordi

Role: primary

Mark Petrie, MBChB

Role: primary

01413302418

Joanna Osmanska, MBChB

Role: backup

Clare Murphy

Role: primary

Ross Campbell, MBChB

Role: primary

Joanna Osmanska, MBChB

Role: backup

Colin Petrie

Role: primary

Peter Cowburn

Role: primary

Paul Foley

Role: primary

Other Identifiers

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2020-004833-19

Identifier Type: -

Identifier Source: org_study_id

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