Dapagliflozin Effect on Rheumatic Mitral Stenosis

NCT ID: NCT05618223

Last Updated: 2022-11-21

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

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-12-01

Study Completion Date

2023-06-30

Brief Summary

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Rheumatic mitral stenosis remains a health problem in developing countries. Progressive fibrosis of the valves and myocardium is the main pathophysiology that plays an important role. Dapagliflozin has various beneficial effects on the heart by reducing fibrosis, reducing inflammation, and improving patient quality of life. However, the role of this therapy is unknown in patients with rheumatic mitral stenosis.

Detailed Description

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This study is an open-label study on Rheumatic Mitral Stenosis patients, carried out at Sebelas Maret University Hospital Sukoharjo, Panti Rahayu Hospital Purwodadi, and Permata Bunda Hospital Purwodadi. Researchers divided 36 Rheumatic Mitral Stenosis patients sequentially into two groups, the first was the dapagliflozin group which would receive dapagliflozin 10 mg once a day and standard treatment. And the second group will only get standard treatment. Each patient will be examined on PICP, MMP-1, MMP-1/TIMP-1 ratio, TGF-β, Net atrioventricular compliance index, NT-pro BNP, and Kansas City Cardiomyopathy Questionnaire on day 1 and one month after the intervention.

Conditions

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Rheumatic Heart Disease Heart Failure Mitral Stenosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Pre and post-test design
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dapagliflozin group

Dapagliflozin 10 mg once a day and standard treatment

Group Type EXPERIMENTAL

Dapagliflozin

Intervention Type DRUG

Dapagliflozin 10 mg once daily in addition to standard therapy

Control group

Standard treatment only.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Dapagliflozin

Dapagliflozin 10 mg once daily in addition to standard therapy

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Severe mitral stenosis by echocardiographic examination of the planimetric method with morphology that supports the etiology of rheumatic
* Heart failure in functional class II-III
* Dapagliflozin naive

Exception Criteria:

* Other significant valve diseases
* Pregnant or breastfeeding
* Unstable hemodynamic conditions including cardiogenic shock
* history of mitral valve replacement/repair or mitral balloon valvuloplasty
* history of hypoglycemia
* eGFR below 25 mmHg
* diffuse pulmonary fibrosis
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universitas Sebelas Maret

OTHER

Sponsor Role lead

Responsible Party

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An Aldia Asrial

An Aldia Asrial, MD, FIHA (Principal investigator)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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An Aldia Asrial, MD

Role: PRINCIPAL_INVESTIGATOR

Universitas Sebelas Maret

Locations

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Sebelas Maret University Hospital

Sukoharjo, Central Java, Indonesia

Site Status

Countries

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Indonesia

Central Contacts

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An Aldia Asrial, MD

Role: CONTACT

+6281229663174

Anggit Pudjiastuti, MD

Role: CONTACT

+6285225036705

Facility Contacts

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An Aldia Asrial, MD

Role: primary

+6281229663174

References

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Banerjee T, Mukherjee S, Ghosh S, Biswas M, Dutta S, Pattari S, Chatterjee S, Bandyopadhyay A. Clinical significance of markers of collagen metabolism in rheumatic mitral valve disease. PLoS One. 2014 Mar 6;9(3):e90527. doi: 10.1371/journal.pone.0090527. eCollection 2014.

Reference Type BACKGROUND
PMID: 24603967 (View on PubMed)

Banerjee T, Mukherjee S, Biswas M, Dutta S, Chatterjee S, Ghosh S, Pattari S, Nanda NC, Bandyopadhyay A. Circulating carboxy-terminal propeptide of type I procollagen is increased in rheumatic heart disease. Int J Cardiol. 2012 Apr 5;156(1):117-9. doi: 10.1016/j.ijcard.2012.01.026. Epub 2012 Feb 1. No abstract available.

Reference Type BACKGROUND
PMID: 22305814 (View on PubMed)

Lin YW, Chen CY, Shih JY, Cheng BC, Chang CP, Lin MT, Ho CH, Chen ZC, Fisch S, Chang WT. Dapagliflozin Improves Cardiac Hemodynamics and Mitigates Arrhythmogenesis in Mitral Regurgitation-Induced Myocardial Dysfunction. J Am Heart Assoc. 2021 Apr 6;10(7):e019274. doi: 10.1161/JAHA.120.019274. Epub 2021 Mar 20.

Reference Type BACKGROUND
PMID: 33749310 (View on PubMed)

Nassif ME, Windsor SL, Tang F, Khariton Y, Husain M, Inzucchi SE, McGuire DK, Pitt B, Scirica BM, Austin B, Drazner MH, Fong MW, Givertz MM, Gordon RA, Jermyn R, Katz SD, Lamba S, Lanfear DE, LaRue SJ, Lindenfeld J, Malone M, Margulies K, Mentz RJ, Mutharasan RK, Pursley M, Umpierrez G, Kosiborod M. Dapagliflozin Effects on Biomarkers, Symptoms, and Functional Status in Patients With Heart Failure With Reduced Ejection Fraction: The DEFINE-HF Trial. Circulation. 2019 Oct 29;140(18):1463-1476. doi: 10.1161/CIRCULATIONAHA.119.042929. Epub 2019 Sep 16.

Reference Type BACKGROUND
PMID: 31524498 (View on PubMed)

Ye Y, Bajaj M, Yang HC, Perez-Polo JR, Birnbaum Y. SGLT-2 Inhibition with Dapagliflozin Reduces the Activation of the Nlrp3/ASC Inflammasome and Attenuates the Development of Diabetic Cardiomyopathy in Mice with Type 2 Diabetes. Further Augmentation of the Effects with Saxagliptin, a DPP4 Inhibitor. Cardiovasc Drugs Ther. 2017 Apr;31(2):119-132. doi: 10.1007/s10557-017-6725-2.

Reference Type BACKGROUND
PMID: 28447181 (View on PubMed)

Li G, Zhao C, Fang S. SGLT2 promotes cardiac fibrosis following myocardial infarction and is regulated by miR-141. Exp Ther Med. 2021 Jul;22(1):715. doi: 10.3892/etm.2021.10147. Epub 2021 May 3.

Reference Type BACKGROUND
PMID: 34007324 (View on PubMed)

Other Identifiers

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Dapa-Rhemis

Identifier Type: -

Identifier Source: org_study_id

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