Adding extra diuretics to standard care for acute decompensated heart failure

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This Phase 2 interventional study compares three different add-on diuretic strategies—empagliflozin, acetazolamide, and metolazone—given alongside loop diuretics in adults admitted with acute decompensated heart failure and signs of volume overload. Eligible hospitalized patients will be assigned one of the three add-on therapies and monitored for decongestion, kidney function, blood pressure, and adverse events. Key exclusions include type 1 diabetes, severe renal impairment (eGFR <30 mL/min/1.73 m2), cardiogenic shock, very low systolic blood pressure, recent use of SGLT2 or thiazide(-like) diuretics, and pregnancy. The trial is conducted at Tanta University and focuses on short-term efficacy and safety outcomes during hospitalization.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Male or female patients older than 18 years.
2. Hospital admission with clinical diagnosis of acute decompensated heart failure with at least one clinical sign of volume overload (e.g. edema, ascites confirmed by echography or pleural effusion confirmed by chest X-ray or echography).

Exclusion Criteria:

1. Type 1 diabetes.
2. Chronic kidney disease with estimated glomerular filtration rate (eGFR) \<30 mL/min per 1.73 m² or end-stage kidney failure with the need for chronic dialysis treatment.
3. A systolic blood pressure of less than 90 mmHg.
4. Cardiogenic shock.
5. Receipt of acetazolamide maintenance therapy.
6. Receipt of an SGLT2 inhibitor, thiazide, or thiazide-like diuretic in the 48 hrs before randomization.
7. Any cause of heart failure leading to decompensation that will need urgent management (eg, acute coronary syndrome, unstable arrhythmias, acute pulmonary embolism).
8. Pregnant or breastfeeding women.
9. Moderate to severe anemia.

Where it's running

• Tanta university
  Tanta, Egypt Recruiting

Study contacts

• Principal investigator: Dalia A Gomaa, MSc in clinical pharmacy — Tanta University
• Study coordinator: Dalia A Gomaa, MSc in clinical pharmacy
• Email: dalia_gomaa@pharm.tanta.edu.eg
• Phone: +20+01063410525

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.