The Effect of Liraglutide on Left Ventricular Function in Chronic Heart Failure Patients With and Without Type 2 Diabetes Mellitus
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Purpose
Type 2 diabetes (T2D) is a major risk factor of chronic heart failure (CHF). Glycemic control in patients with the combination of T2D and CHF is complicated and the currently available treatments have proven to be inadequate in clinical trials.
Objectives To investigate the effect of Liraglutide compared to placebo on left ventricular ejection fraction (LVEF) in CHF patients with and without T2D.
Multicenter, randomized, double blind study of 240 patients with documented systolic CHF (50% with T2DM) will be randomised. The effect of Liraglutide on left ventricular systolic and diastolic function will be evaluated by advanced echocardiography
Primary outcome parameter is change in LVEF from visit 1 to week 24.
| Condition | Intervention |
|---|---|
|
Hyperglycemia Chronic Heart Failure |
Drug: liraglutide Drug: placebo |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Randomised, Double-blind, Placebo-controlled Study of the Effect of LIraglutide on Left VEntricular Function in Chronic Heart Failure Patients With and Without Type 2 Diabetes (The LIVE-study) |
- Change in Left ventricular function from visit 1 to week 24, measured by Ecco [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]Primary objective: To investigate the effect of Liraglutide 1.8 mg once daily compared to placebo on left ventricular function in Chronic heart faillure patients with and without type 2 diabetes after 24 weeks of treatment.
- left ventricular diastolic function [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]Secondary objectives: To investigate the effect of Liraglutide 1.8 mg once daily compared to placebo on left ventricular diastolic function, on plasma levels of NT-proBNP, on symptoms of heart failure and quality of life over 24 weeks of treatment.
| Estimated Enrollment: | 240 |
| Study Start Date: | November 2011 |
| Estimated Study Completion Date: | March 2014 |
| Estimated Primary Completion Date: | March 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Liraglutid
Liraglutid
|
Drug: liraglutide
1.8 mg sc QOD
Other Name: Victoza
|
|
Placebo Comparator: Placebo
Placebo
|
Drug: placebo
1 U sc QOD
Other Name: placebo
|
Detailed Description:
Background The number of patients with diabetes in Denmark has doubled in the preceding 10-years period and has now increased to 271.000 individuals (5% of the population). T2D is a major risk factor of CHF and CHF per se is associated with insulin resistance, thus T2D and CHF often co-exists, and is associated with markedly impaired prognosis. Glycemic control in patients with the combination of T2D and CHF is complicated and the currently available treatments have proven to be inadequate in clinical trials. Therefore, new treatment modalities of hyperglycaemia in CHF are warranted.
Glucagon-like peptide 1 (GLP-1) is a naturally existing hormone, which is secreted from the incretine system. A beneficial effect of GLP-1 on cardiac function has recently been suggested in small clinical studies, demonstrating improved left ventricular ejection fraction (LVEF) in both diabetic and non-diabetic patients. Liraglutide (Victoza®) is a GLP-1-analogue developed for the treatment of T2D. However, the impact of Liraglutide on cardiac function is currently under investigation.
Objectives Primary objective: To investigate the effect of Liraglutide 1.8 mg once daily compared to placebo on LVEF in CHF patients with and without T2D after 24 weeks of treatment.
Secondary objectives: To investigate the effect of Liraglutide 1.8 mg once daily compared to placebo on left ventricular diastolic function, on plasma levels of NT-proBNP, on symptoms of heart failure and quality of life over 24 weeks of treatment.
Design Multicenter, randomized, double blind study evaluating the impact of 24 weeks treatment of Liraglutide versus placebo on cardiac function in CHF patients with and without T2D.
Population A total of 240 patients with documented systolic CHF (50% with T2DM) will be randomised. The effect of Liraglutide on left ventricular systolic and diastolic function will be evaluated by advanced echocardiography using 2D, 3D, and tissue Doppler imaging.
Primary outcome parameter is change in LVEF from visit 1 to week 24
Perspectives Irrespective of the outcome, the study will contribute with essential information regarding treatment of CHF. Potentially Liraglutide can improve heart function substantially, thus changing the prognosis of CHF-patients worldwide.
Eligibility| Ages Eligible for Study: | 30 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Able to understand the written patient information and to give informed consent
- CHF, NYHA-class I, II or III at visit 0
- LVEF ≤45 %
- Age 30 to 85 (both inclusive)
- Stable pharmacological treatment of heart failure according to ESC guidelines for the last 3 months prior to randomisation (visit 1)
For patients with diabetes exclusively:
- T2D (WHO criteria), diagnosed at least 3 months prior to visit 0
- Patients with diabetes must be either untreated or treated with one or more oral anti-diabetic drugs or treated with human NPH-insulin or long-acting insulin analogue, alone or in combination with oral drugs
- Stable and optimal dose of anti diabetic treatment for 30 days prior to randomisation (visit 1)
Exclusion Criteria:
- Myocardial infarction (MI), unstable angina or coronary revascularization within the last three months prior to visit 1
- Hospitalisation due to incompensated heart disease within 30 days prior to randomisation (visit 1)
- CHF (NYHA class IV)
- ECG suggestive of malign ventricular arrhythmia at visit 0
- Type 1 diabetes
- HbA1c > 10% measured at visit 0
- Use of GLP-1 receptor agonists (Exenatide, Liraglutide or other) or glitazones, pramlintide or any DPP-IV inhibitor within 30 days prior to randomisation (visit 1)
- Known or suspected hypersensitivity to trial product or related products
- Alcohol/drug abuse
- Pregnant or nursing women
- Fertile women not using chemical (tablet/pill, depot injection of progesterone, subdermal gestagen implantation, hormonal vaginal ring or transdermal hormonal patch) or mechanical (spirals) contraceptives
- Cancer unless in complete remission for ≥5 years
- Liver disease with elevated plasma alanine aminotransferase (ALT) of more than three times the upper limit of normal (measured at visit 0 with the possibility of one repeat analysis within a week, and the last measured value as being conclusive)
- Inflammatory bowel disease
- Acute or chronic pancreatitis
- Gastroparesis
- Compromised kidney function (eGFR < 30 ml/min), dialysis or kidney transplantation
- History of thyroidea adenoma or carcinoma
- Severely elevated blood pressure (systolic >180 mmHg and/or diastolic >105 mmHg)
- Other concomitant disease or treatment that according to the investigator's assessment makes the patient unsuitable for study participation
- Simultaneous participation in any other clinical intervention trial
- Receipt of an investigational drug with 30 days prior to visit 0
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Flyvbjerg, Allan, DMSc |
| ClinicalTrials.gov Identifier: | NCT01472640 History of Changes |
| Other Study ID Numbers: | DKprotokol(LIVE)v5, 2011-002468-26 |
| Study First Received: | November 11, 2011 |
| Last Updated: | November 17, 2011 |
| Health Authority: | Denmark: The Regional Committee on Biomedical Research Ethics Denmark: Danish Medicines Agency Denmark: Danish Dataprotection Agency |
Keywords provided by Flyvbjerg, Allan, DMSc:
|
CHF, Diabetes; Liraglutid, Ecco |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Heart Failure Hyperglycemia Glucose Metabolism Disorders |
Metabolic Diseases Endocrine System Diseases Heart Diseases Cardiovascular Diseases |
ClinicalTrials.gov processed this record on June 18, 2013