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A Study on Impact of Canagliflozin on Health Status, Quality of Life, and Functional Status in Heart Failure

Canagliflozin: Impact on Health Status, Quality of Life, and Functional Status in Heart Failure

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04252287
Acronym
CHIEF-HF
Enrollment
476
Registered
2020-02-05
Start date
2020-03-10
Completion date
2021-11-09
Last updated
2025-03-30

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Heart Failure

Brief summary

The purpose of this study is to determine the superiority of the effectiveness of canagliflozin 100 milligram (mg) daily versus placebo in participants with symptomatic heart failure (HF) in improving the overall Kansas City Cardiomyopathy Questionnaire (KCCQ) Total Symptom Score (TSS).

Interventions

Participants will receive 100 mg immediate-release, over-encapsulated tablets (as a capsule) orally once daily.

DRUGPlacebo

Participants will receive matching placebo capsules orally once daily.

Sponsors

Janssen Research & Development, LLC
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

\- Have clinically stable symptomatic heart failure (HF) (heart failure with reduced ejection fraction \[HFrEF\] and heart failure with preserved ejection fraction \[HFpEF\]): (A) For HFrEF: (a) ejection fraction (EF) less than or equal to (\<=) 40 percent (%) and (b) a primary diagnosis of HF OR 2 medical visits (including virtual) with a HF diagnosis code in any position in the past 18 months (B) For HFpEF: (a) EF greater than (\>) 40%; (b) a primary diagnosis of HF OR 2 medical visits (including virtual) with a HF diagnosis code in any position in the past 18 months, AND; (C) on a loop diuretic or spironolactone or eplerenone (mineralocorticoid receptor antagonists), in the past 18 months * Have a baseline Kansas City Cardiomyopathy Questionnaire (KCCQ) score of less than or equal to (\<=) 80 prior to randomization * Be able to read and understand English * Possess and have sole use (example: not shared with other users) of smartphone compatible with the Fitbit device * Willing/able to wear the Fitbit device on a regular basis for the 9-month study period

Exclusion criteria

* Currently taking a sodium-glucose co-transporter 2 inhibitor (SGLT2i) or within the last 3 months * History of diabetic ketoacidosis or have type 1 diabetes mellitus (T1DM) * Have acute decompensated HF (exacerbation of symptomatic HF) requiring intravenous diuretics, inotropes, or vasodilators within the last 4 weeks * Have stage 4 or 5 Chronic Kidney Disease (that is, estimated glomerular filtration rate \[eGFR\] \<30 milliliter per minute \[ml/min\] on dialysis) from the most recent assessment * Have a diagnosis of hypotension within 30 days

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Kansas City Cardiomyopathy Questionnaire-Total Symptom Score (KCCQ-TSS) at Week 12Baseline, Week 12Change from baseline in KCCQ-TSS was reported. KCCQ was a 23-item, self-administered questionnaire that measure the participant's perception of their health status, including their heart failure (HF) symptoms, impact on physical and social function and how their HF impacts the quality of life. KCCQ quantifies 7 domains: physical limitations (6 items), symptom stability (1 item), symptom frequency (4 items), symptom burden (3 items), self-efficacy (2 items), quality of life (3 items) and social limitations (4 items). Scores were generated for each domain and scaled from 0 to 100, with 0 denoting the worst and 100 the best possible status. KCCQ-TSS was average of domains- symptom frequency and symptom burden, and transformed to a single score which ranged from 0 (worst) to 100 (the best possible status), where the higher score reflected better health status.

Secondary

MeasureTime frameDescription
Change From Baseline in Total Daily Step Count at Week 12Baseline, Week 12Change from baseline in total daily step count at Week 12 was reported in this outcome measure. The number of steps taken per day was measured using a step activity monitor at baseline and throughout the study. Step count was measured from the Fitbit device data. The Fitbit app on the participant's phone collected all data from the Fitbit device. A negative change from baseline indicated a decrease in the number of daily steps.
Change From Baseline in KCCQ Individual Domain Scores (Physical Limitation and Quality of Life) at Week 12Baseline, Week 12Change from baseline in KCCQ physical limitation score and KCCQ quality of life score were reported. KCCQ was a 23-item, self-administered questionnaire that measure the participant's perception of their health status, including their heart failure (HF) symptoms, impact on physical and social function and how their HF impacts the quality of life. KCCQ quantifies 7 domains: physical limitations (6 items), symptom stability (1 item), symptom frequency (4 items), symptom burden (3 items), self-efficacy (2 items), quality of life (3 items) and social limitations (4 items). Scores were generated for each domain and scaled from 0 to 100, with 0 (worst) and 100 (the best possible status), where the higher score reflected better health status.
Change From Baseline in KCCQ Clinical Summary Score at Week 12Baseline, Week 12Change from baseline in KCCQ-clinical summary score was reported. KCCQ was a 23-item, self-administered questionnaire that measure the participant's perception of their health status, including their heart failure (HF) symptoms, impact on physical and social function and how their HF impacts the quality of life. KCCQ quantifies 7 domains: physical limitations (6 items), symptom stability (1 item), symptom frequency (4 items), symptom burden (3 items), self-efficacy (2 items), quality of life (3 items) and social limitations (4 items). Scores were generated for each domain and scaled from 0 to 100, with 0 denoting the worst and 100 the best possible status. KCCQ-clinical summary score was average of domains- physical limitation and total symptoms (average of symptom frequency and symptom burden), and transformed to a single score which ranged from 0 (worst) -100 (the best possible status), where the higher score reflected better health status.
Change From Baseline in KCCQ Overall Summary Score at Week 12Baseline, Week 12Change from baseline in KCCQ-overall summary score was reported. KCCQ was a 23-item, self-administered questionnaire that measure the participant's perception of their health status, including their heart failure (HF) symptoms, impact on physical and social function and how their HF impacts the quality of life. KCCQ quantifies 7 domains: physical limitations (6 items), symptom stability (1 item), symptom frequency (4 items), symptom burden (3 items), self-efficacy (2 items), quality of life (3 items) and social limitations (4 items). Scores were generated for each domain and scaled from 0 to 100, with 0 denoting the worst and 100 the best possible status. KCCQ- overall summary score was average of domains- physical limitation, total symptoms (average of symptom frequency and symptom burden), quality of life, and social limitation, and transformed to a single score which ranged from 0 (worst) -100 (the best possible status), where the higher score reflected better health status.

Countries

United States

Participant flow

Pre-assignment details

A total of 1,333 participants were screened. Of which, 476 participants were randomized in the study.

Participants by arm

ArmCount
Placebo
Participants received placebo (matched to canagliflozin) capsule orally once daily for 12 weeks.
231
Canagliflozin 100 mg
Participants received canagliflozin 100 milligrams (mg) immediate-release, over-encapsulated tablet (as capsule) orally once daily for 12 weeks.
224
Total455

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath53
Overall StudyLost to Follow-up46
Overall StudyProtocol Violation34
Overall StudyWithdrawal by Subject1916

Baseline characteristics

CharacteristicCanagliflozin 100 mgTotalPlacebo
Age, Continuous62.9 Years
STANDARD_DEVIATION 13.15
63.4 Years
STANDARD_DEVIATION 13.32
63.8 Years
STANDARD_DEVIATION 13.5
Race/Ethnicity, Customized
Asian
1 Participants2 Participants1 Participants
Race/Ethnicity, Customized
Black or African American
35 Participants65 Participants30 Participants
Race/Ethnicity, Customized
Other
4 Participants5 Participants1 Participants
Race/Ethnicity, Customized
White
184 Participants383 Participants199 Participants
Sex: Female, Male
Female
105 Participants204 Participants99 Participants
Sex: Female, Male
Male
119 Participants251 Participants132 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
5 / 2313 / 224
other
Total, other adverse events
0 / 2310 / 224
serious
Total, serious adverse events
36 / 23133 / 224

Outcome results

Primary

Change From Baseline in Kansas City Cardiomyopathy Questionnaire-Total Symptom Score (KCCQ-TSS) at Week 12

Change from baseline in KCCQ-TSS was reported. KCCQ was a 23-item, self-administered questionnaire that measure the participant's perception of their health status, including their heart failure (HF) symptoms, impact on physical and social function and how their HF impacts the quality of life. KCCQ quantifies 7 domains: physical limitations (6 items), symptom stability (1 item), symptom frequency (4 items), symptom burden (3 items), self-efficacy (2 items), quality of life (3 items) and social limitations (4 items). Scores were generated for each domain and scaled from 0 to 100, with 0 denoting the worst and 100 the best possible status. KCCQ-TSS was average of domains- symptom frequency and symptom burden, and transformed to a single score which ranged from 0 (worst) to 100 (the best possible status), where the higher score reflected better health status.

Time frame: Baseline, Week 12

Population: Full analysis set (FAS) included all randomized participants who had received at least one dose of study intervention/medication and had at least one post-baseline KCCQ measurement. Here, N (Overall number of participants analyzed) signifies participants evaluable for this outcome measure.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Kansas City Cardiomyopathy Questionnaire-Total Symptom Score (KCCQ-TSS) at Week 124.9 Score on a scaleStandard Error 1.27
Canagliflozin 100 mgChange From Baseline in Kansas City Cardiomyopathy Questionnaire-Total Symptom Score (KCCQ-TSS) at Week 129.2 Score on a scaleStandard Error 1.27
p-value: 0.01695% CI: [0.8, 7.8]ANCOVA
Secondary

Change From Baseline in KCCQ Clinical Summary Score at Week 12

Change from baseline in KCCQ-clinical summary score was reported. KCCQ was a 23-item, self-administered questionnaire that measure the participant's perception of their health status, including their heart failure (HF) symptoms, impact on physical and social function and how their HF impacts the quality of life. KCCQ quantifies 7 domains: physical limitations (6 items), symptom stability (1 item), symptom frequency (4 items), symptom burden (3 items), self-efficacy (2 items), quality of life (3 items) and social limitations (4 items). Scores were generated for each domain and scaled from 0 to 100, with 0 denoting the worst and 100 the best possible status. KCCQ-clinical summary score was average of domains- physical limitation and total symptoms (average of symptom frequency and symptom burden), and transformed to a single score which ranged from 0 (worst) -100 (the best possible status), where the higher score reflected better health status.

Time frame: Baseline, Week 12

Population: FAS included all randomized participants who had received at least one dose of study intervention/medication and had at least one post-baseline KCCQ measurement. Here, N (Overall number of participants analyzed) signifies participants evaluable for this outcome measure.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in KCCQ Clinical Summary Score at Week 124.7 Score on a scaleStandard Error 1.16
Canagliflozin 100 mgChange From Baseline in KCCQ Clinical Summary Score at Week 128.5 Score on a scaleStandard Error 1.17
Secondary

Change From Baseline in KCCQ Individual Domain Scores (Physical Limitation and Quality of Life) at Week 12

Change from baseline in KCCQ physical limitation score and KCCQ quality of life score were reported. KCCQ was a 23-item, self-administered questionnaire that measure the participant's perception of their health status, including their heart failure (HF) symptoms, impact on physical and social function and how their HF impacts the quality of life. KCCQ quantifies 7 domains: physical limitations (6 items), symptom stability (1 item), symptom frequency (4 items), symptom burden (3 items), self-efficacy (2 items), quality of life (3 items) and social limitations (4 items). Scores were generated for each domain and scaled from 0 to 100, with 0 (worst) and 100 (the best possible status), where the higher score reflected better health status.

Time frame: Baseline, Week 12

Population: FAS included all randomized participants who had received at least one dose of study intervention/medication and had at least one post-baseline KCCQ measurement. Here, N (Overall number of participants analyzed) signifies participants evaluable for this outcome measure. Here, 'n' (number analyzed) signifies participants with available data for each specified category.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in KCCQ Individual Domain Scores (Physical Limitation and Quality of Life) at Week 12KCCQ-Physical Limitation4.8 Score on a scaleStandard Error 1.26
PlaceboChange From Baseline in KCCQ Individual Domain Scores (Physical Limitation and Quality of Life) at Week 12KCCQ-Quality of Life9.1 Score on a scaleStandard Error 1.4
Canagliflozin 100 mgChange From Baseline in KCCQ Individual Domain Scores (Physical Limitation and Quality of Life) at Week 12KCCQ-Physical Limitation7.8 Score on a scaleStandard Error 1.27
Canagliflozin 100 mgChange From Baseline in KCCQ Individual Domain Scores (Physical Limitation and Quality of Life) at Week 12KCCQ-Quality of Life12.4 Score on a scaleStandard Error 1.41
Secondary

Change From Baseline in KCCQ Overall Summary Score at Week 12

Change from baseline in KCCQ-overall summary score was reported. KCCQ was a 23-item, self-administered questionnaire that measure the participant's perception of their health status, including their heart failure (HF) symptoms, impact on physical and social function and how their HF impacts the quality of life. KCCQ quantifies 7 domains: physical limitations (6 items), symptom stability (1 item), symptom frequency (4 items), symptom burden (3 items), self-efficacy (2 items), quality of life (3 items) and social limitations (4 items). Scores were generated for each domain and scaled from 0 to 100, with 0 denoting the worst and 100 the best possible status. KCCQ- overall summary score was average of domains- physical limitation, total symptoms (average of symptom frequency and symptom burden), quality of life, and social limitation, and transformed to a single score which ranged from 0 (worst) -100 (the best possible status), where the higher score reflected better health status.

Time frame: Baseline, Week 12

Population: FAS included all randomized participants who had received at least one dose of study intervention/medication and had at least one post-baseline KCCQ measurement. Here, N (Overall number of participants analyzed) signifies participants evaluable for this outcome measure.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in KCCQ Overall Summary Score at Week 126.2 Score on a scaleStandard Error 1.18
Canagliflozin 100 mgChange From Baseline in KCCQ Overall Summary Score at Week 129.5 Score on a scaleStandard Error 1.18
Secondary

Change From Baseline in Total Daily Step Count at Week 12

Change from baseline in total daily step count at Week 12 was reported in this outcome measure. The number of steps taken per day was measured using a step activity monitor at baseline and throughout the study. Step count was measured from the Fitbit device data. The Fitbit app on the participant's phone collected all data from the Fitbit device. A negative change from baseline indicated a decrease in the number of daily steps.

Time frame: Baseline, Week 12

Population: FAS included all randomized participants who had received at least one dose of study intervention/medication and had at least one post-baseline KCCQ measurement. Here, N (Overall number of participants analyzed) signifies participants evaluated for this outcome measure.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Total Daily Step Count at Week 12-74.9 Daily step countStandard Error 112.85
Canagliflozin 100 mgChange From Baseline in Total Daily Step Count at Week 12-45.1 Daily step countStandard Error 113.78
p-value: 0.85295% CI: [-284.4, 344.1]ANCOVA

Source: ClinicalTrials.gov · Data processed: Feb 15, 2026