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Trial registered on ANZCTR
Registration number
ACTRN12624000270516p
Ethics application status
Submitted, not yet approved
Date submitted
13/02/2024
Date registered
18/03/2024
Date last updated
18/03/2024
Date data sharing statement initially provided
18/03/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
The effect of substantial weight loss with tirzepatide on heart failure with preserved ejection fraction in people with obesity
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Scientific title
The effect of substantial weight loss with tirzepatide on heart failure with preserved ejection fraction in people with obesity
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Secondary ID [1]
311534
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nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Heart Failure
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Obesity
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Condition category
Condition code
Cardiovascular
329603
329603
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0
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Other cardiovascular diseases
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Diet and Nutrition
329925
329925
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0
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Obesity
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention group will receive tirzepatide (Eli Lilly)- titrated as per manufacturer's guidelines until the maximum dose (or tolerated dose) of 15mg weekly subcutaneous injection for 12-months. Starting at 2.5mg weekly, increasing by 2.5mg increments every 4 weeks until the maximum dose (15mg) is achieved.
There are no laboratory tests that monitor adherence to this medication.
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Intervention code [1]
327988
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Treatment: Drugs
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Comparator / control treatment
Comparator is a placebo of normal saline 0.9% which will be provided in identical vials to the study drug. Participants will be randomized to each group.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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A change in the mean pulmonary artery pressure (MPAP) during exercise
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Assessment method [1]
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Pulmonary capillary wedge pressure (PWCP) measured during an exercise right-heart catheterization as reflective of MPAP.
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Timepoint [1]
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Baseline and 12-months after treatment with study drug.
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Secondary outcome [1]
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An change in functional exercise capacity.
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Assessment method [1]
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Cardiopulmonary exercise test (CPET) on an exercise bike using a standard ramp test protocol to measure maximum oxygen uptake (peak VO2) and ventilatory threshold (v-slope).
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Timepoint [1]
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Baseline and 12-months after treatment with the study drug
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Secondary outcome [2]
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Change in myocardial triglyceride content
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Assessment method [2]
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Cardiac MRI
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Timepoint [2]
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Baseline and 12-months after treatment with the study drug
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Secondary outcome [3]
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Structural muscular changes
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Assessment method [3]
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A whole-body dual energy X-ray absorptiometry (DXA) scan will be performed to measure body composition and hip and lumbar spine bone mineral density.
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Timepoint [3]
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Baseline and 12-months after treatment with the study drug
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Secondary outcome [4]
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Changes in cardiac biomarkers.
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Assessment method [4]
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NT-proBNP, MRproANP, MR-proADM, GDF-15, hsCRP, hsTnT and ST2 using standard laboratory assays as provided by the Alfred Hospital Pathology Department
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Timepoint [4]
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Baseline and 12-months after treatment with the study drug
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Secondary outcome [5]
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Changes in quality of life
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Assessment method [5]
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Minnesota Living with Heart Failure Questionnaire
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Timepoint [5]
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Baseline and 12-months after treatment with the study drug
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Secondary outcome [6]
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Structural changes observed on echocardiogram
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Assessment method [6]
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Echocardiographic measurements: change in lateral and septal e’, left atrial size and global longitudinal strain. Cardiac MRI: LVEF, LV mass indexed for BSA and epicardial fat volume, pre and post contrast T1 time, extracellular volume.
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Timepoint [6]
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Baseline and 12-months following treatment with the study drug
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Eligibility
Key inclusion criteria
• Are greater than 18 years old,
• Have a BMI of 30 or more, or a BMI of 27 or more and at least one weight-related complication (e.g., hypertension, dyslipidemia, obstructive sleep apnea, or cardiovascular disease),
• Report one or more unsuccessful dietary effort to lose weight.
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Diabetes
• Change in body weight of more than 5 kg within 90 days before screening
• Previous or planned surgical treatment for obesity
• Treatment with a medication that promotes weight loss within 90 days before screening
• Ejection fraction <50% (current or prior)
• Pregnancy
• Significant valvular heart disease (greater than mild stenosis, greater than moderate regurgitation)
• Pulmonary arterial hypertension
• Constrictive pericarditis
• Primary cardiomyopathies
• Heart transplantation
• Significant pulmonary disease
• History of pancreatitis
• Previous bariatric surgery
• Diagnosis of gastroparesis
• Diagnosis of cancer within the past 5 years (excluding skin cancers)
• Personal or family history of medullary thyroid cancer
• Patients not eligible for Medicare
• Patients who are not fluent in English.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by phone/fax/computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation). Using REDCap randomization tool.
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/04/2024
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Actual
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Date of last participant enrolment
Anticipated
1/04/2026
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Actual
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Date of last data collection
Anticipated
1/04/2027
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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The Alfred - Melbourne
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Recruitment postcode(s) [1]
42049
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3004 - Melbourne
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Investigator Initiated - PI's Research Stipend
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Address [1]
315829
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Country [1]
315829
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Australia
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Funding source category [2]
315830
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Other Collaborative groups
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Name [2]
315830
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Baker Heart and Diabetes Institute
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Address [2]
315830
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Country [2]
315830
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
Baker Heart and Diabetes Institute
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
317958
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Address [1]
317958
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Country [1]
317958
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
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https://www.alfredhealth.org.au/research/ethics-research-governance
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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06/03/2024
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Approval date [1]
314685
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Ethics approval number [1]
314685
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Summary
Brief summary
Diabetics on the study drug, tirzepatide, have been shown to experience significant weight loss during their treatment with this medication. Our study aims to identify its mechanism of action for patients with heart failure with preserved ejection fraction (HFpEF) and examine if treatment with this medication can significantly improve structural, functional, and symptomatic outcomes of patients with heart failure.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Sarah Gutman
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Address
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Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne VIC 3004
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Country
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Australia
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Phone
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+610385321302
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Eloise Thompson
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Address
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Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne VIC 3004
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Country
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Australia
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Phone
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+61385321862
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Eloise Thompson
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Address
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Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne VIC 3004
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Country
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Australia
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Phone
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+61385321862
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Fax
132396
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Email
132396
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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