Deprescribing Beta-Blockers in Elders With Heart Failure With Preserved Ejection Fraction (DEPRESCRIBE-HFpEF)
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Placebo (matching), Beta-blockers.
- Кому может быть актуально
- Состояния в реестре: Heart Failure, HFpEF, HFpEF - Heart Failure With Preserved Ejection Fraction. Базовые параметры: от 60 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- США
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Determining Evidence in a Placebo-Controlled, Randomized Experiment Studying Continuation vs. Removal of Inessential Beta-Blockers in Elders With Heart Failure With Preserved Ejection Fraction (DEPRESCRIBE-HFpEF)
Обзор
The goal of this study is to learn whether stopping beta-blockers can help older adults with heart failure with preserved ejection fraction (HFpEF) feel better and function better. This study will test whether "deprescribing" or stopping these medications in a careful, guided way can improve symptoms and quality of life. Participants will be randomly assigned to one of two groups: Deprescribing group: Beta-blockers are gradually reduced using capsules that contain decreasing doses. Usual care group: Beta-blockers are continued at the usual dose in look-alike capsules. All participants will: * Take study medicine for about 4 months * Have their blood pressure and heart rate monitored * Complete regular phone calls and questionnaires about how they are feeling This study does not involve any experimental medication. Participants active involvement in the study will last approximately 4 months. During these 4 months they will have 8 scheduled telephone visits.
Вмешательства
- Препарат Placebo (matching)
Beta-blocker dosage will be reduced over the course of 4 weeks until the participant is completely off of beta-blocker and transitioned to matching placebo capsules. - Препарат Beta-blockers
Participants will continue their pre-enrollment beta-blocker at the same dose. The beta-blocker agent may include atenolol, bisoprolol, carvedilol, metoprolol succinate, or metoprolol tartrate. Medication will be provided in matching capsules to maintain blinding.
Первичные конечные точки
- The Hierarchical Composite Endpoint [Срок оценки: From baseline (day 0) to end of the follow-up phase (day 120)]
Вторичные конечные точки (2)
- The change from baseline in patient-reported physical health, as measured by the KCCQ-12 [Срок оценки: Baseline, Day 120]
- The change in patient-reported mental health, as measured by the PROMIS Depression scale [Срок оценки: Baseline, Day 120]
Критерии участия
Критерии включения
- Ambulatory adults age ≥60 years with HFpEF (EF ≥50% based on most recent transthoracic echocardiogram)
- Hospitalized with HF in the past 24 months (defined by diagnostic codes in any position)
- Taking any of the following ß-blockers: atenolol, bisoprolol, carvedilol, metoprolol succinate, or metoprolol tartrate (i.e., pharmacy prescription data)
- Kaiser Permanence Northern California Membership
Критерии исключения
- Alternative etiologies of HFpEF syndrome
- Compelling guideline indication for ß-blocker:
- Prior EF <50% (i.e., based on the structured data field on transthoracic echocardiogram)
- Current anginal symptoms (i.e., based on the Rose Angina single-question screener for angina)
- MI (i.e., diagnostic codes) and/or coronary revascularization (i.e., procedure codes) within 3 years
- Hospitalization for a primary discharge diagnosis of atrial fibrillation or atrial flutter in the prior 12 months
- Other documented reason in the opinion of the treating provider and/or enrolling clinician-investigator
- Evidence of recent decompensated HF
- Hospitalization for a primary discharge diagnosis of HF within the past 30 days
- Change in loop diuretic pharmacy prescription in the past 30 days (i.e. pharmacy prescription data) (Note: This definition is based on documented prescription changes and does not include short-term dose adjustments that were verbally communicated to the patient by their provider.)
- Estimated life expectancy <6 months (i.e., diagnostic codes)
- Diagnosed dementia (i.e.., diagnostic codes)
- Unable to provide informed consent
- Loss of Kaiser Permanence Northern California Membership
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Четверное слепое
- Основная цель
- Лечение
Центры проведения
США · 1 центр
- Kaiser Permanente Northern California (KPNC) — Pleasanton
Идентификаторы
NCT: NCT07298993 · 24-08027899 · R01AG091005