None listed
Conditions
Interventions
Drug : Treatment group: Macitentan 10mg, Dapagliflozin 10mg or 5mg po tablet q.d. in 24 weeks
Control group: Macitentan placebo, Dapagliflozin 10mg or 5mg po tablet q.d. in 24 weeks
Sponsors
Gachon University Gil Medical Center
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Participants who meet all of the following criteria are eligible to participate in this clinical trial. Screening Visit (Visit 1) 1. A male or female adults aged 19 years or older in South Korea 2. LVEF greater than 40% on echocardiogram performed within 12 weeks prior to screening 3. Presence of heart failure with mildly reduced ejection fraction (HFmrEF) or preserved ejection fraction (HFpEF) accompanied by combined pre- and post-capillary pulmonary hypertension (CpcPH) 4. Meeting all of the following criteria on RHC performed within 48 weeks prior to screening: ? mPAP > 20 mmHg ? PVR > 2 Wood units (WU) ? PAWP > 15 mmHg 5. World Health Organization Functional Class (WHO-FC) II or III at the time of screening 6. If taking any of the following medications at the time of screening, the participant must have been on a stable dose for at least 3 months: - Renin–angiotensin system inhibitors - Beta-blockers - Mineralocorticoid receptor antagonists (aldosterone antagonists) - Sodium–glucose cotransporter-2 (SGLT2) inhibitors - Ivabradine Baseline Visit (Visit 2) 1. World Health Organization Functional Class (WHO-FC) II or III at the time of baseline visit
Exclusion criteria
Exclusion criteria: Screening Visit (Visit 1) 1. Known hypersensitivity to the active ingredients (Macitentan, Dapagliflozin) or any excipients of the investigational medicinal product 2. Pregnant or breastfeeding women, or those who do not agree to use at least two appropriate contraceptive methods* (self or partner) during the clinical trial period and for 30 days after the last administration of the investigational medicinal product (for male participants, those who do not agree to refrain from sperm donation) *: ?Surgical sterilization (e.g., vasectomy) or intrauterine device (IUD; copper IUD or hormone-releasing intrauterine system), ?Non-oral hormonal contraceptive or spermicide in combination with a barrier method, ?Cervical cap or diaphragm used in combination with a male condom. 3. Participants with type 1 diabetes mellitus or secondary diabetes mellitus 4. Participants with metabolic acidosis, such as diabetic ketoacidosis 5. Participants diagnosed with pulmonary hypertension other than WHO Group 2 pulmonary hypertension (i.e., WHO Group 1, 3, 4, or 5) ? Group 1: Pulmonary arterial hypertension ? Group 3: Pulmonary hypertension associated with lung diseases and/or hypoxia ? Group 4: Chronic thrombo-embolic pulmonary hypertension ? Group 5: Pulmonary hypertension with unclear and/or multifactorial mechanisms 6. Participants who meet the following criteria on RHC performed within 48 weeks prior to screening: ? PAWP = 15 mmHg 7. History of taking any of the following medications within 4 weeks prior to screening: - Calcium channel blockers - Endothelin receptor antagonists - Phosphodiesterase type 5 inhibitors (PDE5i) - Riociguat, Vericiguat - Prostacyclin (PC) analogs or prostacyclin receptor agonists - Activin signaling inhibitors 8. History of any of the following medical conditions, surgeries, or procedures: ? Myocardial infarction, coronary artery bypass grafting, or percutaneous coronary intervention (PCI) within 3 months prior to screening ? Uncontrolled tachycardia (>110 bpm) due to atrial fibrillation or atrial flutter ? History of heart transplantation or implantation of a ventricular assist device, or planned to undergo such procedures 9. eGFR = 30 mL/min/1.73 m² or AST or ALT = 2.5 × ULN 10. Urinary tract infection, genital infection (including fungal infections), or voiding disorder within 24 weeks prior to screening 11. Hemoglobin < 9 g/dL at the time of screening 12. Participants with genetic disorders such as galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption 13. Known hypersensitivity to soybean oil or history of soybean oil allergy 14. Known hypersensitivity to soy or peanuts 15. Participation in another clinical trial involving administration/application of an investigational medicinal product or medical device within 3 months prior to screening Baseline Visit (Visit 2) 1. Participants who, upon re-confirmation of inclusion/exclusion criteria at the baseline visit, have any disqualifying condition 2. Any other condition that, in the opinion of the investigator, makes the participant unsuitable for participation in this clinical trial
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Hierarchical outcome component(Change in PVR, Change in NT-proBNP, Change in 6MWD, Change in KCCQ-CSS) | — |
Secondary
| Measure | Time frame |
|---|---|
| Change in Pulmonary Vascular Resistance (PVR) from Baseline to Week 24;Change in Mean Pulmonary Arterial Pressure (mPAP) from Baseline to Week 24;Change in Pulmonary Arterial Wedge Pressure (PAWP) from Baseline to Week 24;Change in 6-Minute Walk Distance from Baseline to Week 24;Change in Oxygen Saturation (SpO2) Difference Before and After 6-Minute Walk Test from Baseline to Week 24;Change in N-terminal pro-brain natriuretic peptide (NT-proBNP) from Baseline to Week 24;Change in Tricuspid Regurgitation Velocity (TRV) from Baseline to Week 24;Change in Tricuspid Annular Plane Systolic Excursion (TAPSE) from Baseline to Week 24;Use of Intravenous Diuretics During Treatment Period (Visit 2 to Visit 4);Rate of Hospitalization Due to Heart Failure During Treatment Period (Visit 2 to Visit 4);Number of Days Hospitalized for Heart Failure During Treatment Period (Visit 2 to Visit 4);Number of Deaths (Cardiovascular and All-Cause) During Treatment Period (Visit 2 to Visit 4);Change in Mean Right Atrial Pressure (mRAP) from Baseline to Week 24;Change in Cardiac Index (CI) from Baseline to Week 24;Change in Mixed Venous Oxygen Saturation (SvO2) from Baseline to Week 24;Change in Left Atrial Volume Index (LAVI) from Baseline to Week 24;Change in Tricuspid Valve Systolic Tissue Velocity (TV S’ velocity) from Baseline to Week 24;Change in Right Atrial Area (RA area) from Baseline to Week 24;Change in Presence of Pericardial Effusion from Baseline to Week 24;Change in Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS) from Baseline to Week 24 | — |
Countries
Korea, Republic of
Contacts
Public ContactKyung Eun Ha
Gachon University Gil Medical Center
Outcome results
None listed