NCT04083339

Brief Summary

This is a multicenter, randomized, placebo-controlled, 2-part study to evaluate the safety and efficacy of AT-001 in adult patients (N=675) with Diabetic Cardiomyopathy at high risk of progression to overt heart failure.

Trial Health

67
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
675

participants targeted

Target at P75+ for phase_3

Timeline
Completed

Started Sep 2019

Longer than P75 for phase_3

Geographic Reach
10 countries

79 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 23, 2019

Completed
18 days until next milestone

First Posted

Study publicly available on registry

September 10, 2019

Completed
10 days until next milestone

Study Start

First participant enrolled

September 20, 2019

Completed
4.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2023

Completed
2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2025

Completed
Last Updated

December 8, 2022

Status Verified

December 1, 2022

Enrollment Period

4.2 years

First QC Date

August 23, 2019

Last Update Submit

December 7, 2022

Conditions

Keywords

Type 2 DiabetesAldose Reductase InhibitorStage B Heart FailureStage C Heart FailureCardiopulmonary Exercise Test

Outcome Measures

Primary Outcomes (1)

  • Peak VO2 during cardio-pulmonary exercise test (CPET);

    Changes in Peak VO2 during cardio-pulmonary exercise test (CPET) from baseline to approximately Month 15 (15-18 months). A CPET may be repeated at approximately Month 27 (27-30 months).

    15 months after randomization]

Secondary Outcomes (3)

  • Progression to overt heart failure (Stage C Heart Failure)

    27 months after randomization

  • Changes in NT-proBNP

    27 months after randomization

  • Changes in the modified Kansas City Cardiomyopathy Questionnaire (KCCQ) score

    27 months after randomization

Other Outcomes (2)

  • Worsening of diabetic cardiomyopathy

    15 and 27 months after randomization

  • Changes in echocardiographic parameters

    27 months after randomization

Study Arms (3)

AT-001 High dose

EXPERIMENTAL

The total daily doses will be of 3g. The dose selection and the frequency of dosing was based on the results of the phase 1/2 study demonstrating that 3g/day of AT-001 is capable of producing the maximum inhibition of the production of sorbitol (a pharmacodynamic biomarker of biological activity).

Drug: AT-001

AT-001 Low Dose

EXPERIMENTAL

The total daily doses will be of 2g. The dose selection and the frequency of dosing was based on the results of the phase 1/2 study demonstrating that 2g/day of AT-001 is capable of producing a sufficient inhibition of the production of sorbitol (a pharmacodynamic biomarker of biological activity).

Drug: AT-001

Placebo Comparator

PLACEBO COMPARATOR

Placebo capsules will be used as comparator

Drug: Placebo

Interventions

AT-001DRUG

AT-001 will be administered as 3 capsules twice daily, before breakfast and before dinner. At present AT001 is the sole name for the active substance. No INN/genetic name is available to date

AT-001 High doseAT-001 Low Dose

Matching placebo will be administered as 3 capsules twice daily, before breakfast and before dinner

Placebo Comparator

Eligibility Criteria

Age40 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Type 2 Diabetes Mellitus
  • Diabetic cardiomyopathy
  • Peak VO2 \< 75% of predicted normal value based on age and gender

You may not qualify if:

  • Prior diagnosis or signs/symptoms of overt/symptomatic heart failure / stage C heart failure
  • Prior echocardiogrphic measurement of ejection fraction (EF) \< 40%
  • Prior acute coronary syndrome (ACS), coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), coronary artery disease (CAD) or stroke
  • Severe or moderate cardiac valve disease requiring intervention
  • Clinically significant arrhythmia
  • Prior diagnosis of congenital, infective, toxic, infiltrative, post-partum, or hypertrophic cardiomyopathy
  • Blood pressure \> 140 mmHg (systolic) or \> 90 mmHg (diastolic) at screening
  • HbA1c \>8.5% at screening
  • Severe disease that would impact the performance of a cardio-pulmonary exercise test

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (79)

Westside Medical Associates of Los Angeles

Beverly Hills, California, 90211, United States

Location

University of California, San Diego (UCSD)

La Jolla, California, 92093, United States

Location

Clinical Trials Research

Lincoln, California, 95648, United States

Location

University of California - Irvine Medical Center

Orange, California, 92868, United States

Location

Metabolic Institute of America

Tarzana, California, 91356, United States

Location

Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center

Torrance, California, 90509, United States

Location

ALL Medical Research, LLC

Cooper City, Florida, 33024, United States

Location

New Generation of Medical Research

Hialeah, Florida, 33016, United States

Location

Broward Research Center

Pembroke Pines, Florida, 33024, United States

Location

Progressive Medical Research

Port Orange, Florida, 32127, United States

Location

UnityPoint Health - Methodist Hospital

Peoria, Illinois, 61602, United States

Location

Brigham and Women's Hospital

Boston, Massachusetts, 02115, United States

Location

Universty of Mississippi Medical Center

Jackson, Mississippi, 39216, United States

Location

St. Louis Heart and Vascular Cardiology

St Louis, Missouri, 63136, United States

Location

Chear Center LLC

The Bronx, New York, 10455, United States

Location

Montefiore Medical Center

The Bronx, New York, 10467, United States

Location

Cleveland Clinic

Cleveland, Ohio, 44195, United States

Location

Remington Davis, Inc.

Columbus, Ohio, 43215, United States

Location

South Oklahoma Heart Research

Oklahoma City, Oklahoma, 73135, United States

Location

Mountain View Clinical Research - Greer

Greer, South Carolina, 29651, United States

Location

Mountain View Clinical Research

Greer, South Carolina, 29651, United States

Location

Holston Medical Group

Kingsport, Tennessee, 37660, United States

Location

Dallas Diabetes Research Center

Dallas, Texas, 75230, United States

Location

Southwest Family Medicine Associates

Dallas, Texas, 75235, United States

Location

University of Texas Southwestern

Dallas, Texas, 75390, United States

Location

Juno Research, LLC - Northwest Site

Houston, Texas, 77040, United States

Location

Juno Research, LLC - Southwest Houston Site

Houston, Texas, 77074, United States

Location

FMC Science

Lampasas, Texas, 76550, United States

Location

Prince Charles Hospital

Chermside, Queensland, 4032, Australia

Location

CORE Research Group Pty. Ltd.

Milton, Queensland, 4064, Australia

Location

AusTrials

Taringa, Queensland, 4068, Australia

Location

University of Tasmania at Hobart

Hobart, Tasmania, 7001, Australia

Location

Barwon Health-University Hospital Geelong

Geelong, Victoria, 3220, Australia

Location

Austin Health

Heidelberg, Victoria, 3084, Australia

Location

Baker Heart and Diabetes Institute

Melbourne, Victoria, 3004, Australia

Location

C-Endo - Endocrinology Centre

Calgary, Alberta, T2V 4J2, Canada

Location

BC Diabetes

Vancouver, British Columbia, V5Y 3W2, Canada

Location

LMC Diabetes & Endocrinology Ltd. - Brampton

Brampton, Ontario, L6S 0C6, Canada

Location

LMC Diabetes & Endocrinology Ltd. - Thornhill

Concord, Ontario, L4K 4M2, Canada

Location

LMC Diabetes & Endocrinology Ltd. - Etobicoke

Etobicoke, Ontario, M9R 4E1, Canada

Location

Centre for Studies in Family Medicine, Western Centre for Public Health and Family Medicine, Western University

London, Ontario, N6G 2M1, Canada

Location

LMC Diabetes & Endocrinology Ltd. - Toronto

Toronto, Ontario, M4G 3E8, Canada

Location

Ecogene-21

Chicoutimi, Quebec, G7H 7K9, Canada

Location

Institut Universitaire de Cardiologie et de Pneumologie De Quebec

Québec, Quebec, G1V 4G5, Canada

Location

Edumed s.r.o.

Jaroměř, 55101, Czechia

Location

Nemocnice Pardubickeho kraje, a.s., Nemocnice Pardubice

Pardubice, 532 03, Czechia

Location

Vseobecna fakultni nemocnice v Praze

Prague, 128 08, Czechia

Location

Hôpital Jean-Verdier - AP-HP; Service Endocrinologie Diabétologie Nutrition

Bondy, 93140, France

Location

CHU Henri Mondor

Créteil, 94000, France

Location

CHU de Nantes, Clinique d'Endocrinologie

Nantes, 44093, France

Location

Centre Hospitalier de Valenciennes

Valenciennes, 59322, France

Location

Klinikum Frankfurt (Oder) GmbH

Frankfurt (Oder), Brandenburg, 15236, Germany

Location

Herz-und Diabeteszentrum NRW Universitaetsklinik der Ruhr-Universitaet Bochum

Bad Oeynhausen, North Rhine-Westphalia, 32545, Germany

Location

Cardiologicum Pirna und Dresden

Dresden, Saxony, 01277, Germany

Location

Klinische Forschung Berlin GbR

Berlin, 10787, Germany

Location

ZKS - Zentrum Klinische Studien Sudbrandenburg GmbH

Elsterwerda, 04910, Germany

Location

Erik Yee Mun George Fung

Shatin, Hong Kong

Location

Prince of Wales Hospital; Chinese University of Hong Kong; Dept of Medicine and Therapeutics

Shatin, Hong Kong

Location

Centrum Chorob Serca w USK

Wroclaw, Borowska, 50-556, Poland

Location

NZOZ Specjalistyczny Osrodek Internistyczno - Diabetologiczny

Bialystok, 15-435, Poland

Location

Topolowa MEDICENTER Mrózek & wspólnicy sp.j.

Krakow, 31-506, Poland

Location

Centrum Twojego Zdrowia

Krakow, 31-526, Poland

Location

ETG Lodz

Lodz, 90-302, Poland

Location

Praktyka Lekarska Ewa Krzyzagorska

Poznan, 61-655, Poland

Location

Prywatny Gabinet Lekarski Centrum Medyczne Diabetika

Radom, 26-600, Poland

Location

Centrum Medyczne Medyk Stanislaw Mazur Sp. z o.o. SK

Rzeszów, 35-005, Poland

Location

4 Wojskowy Szpital Kliniczny z Poliklinika Samodzielny Publiczny ZOZ we Wroclawiu

Wroclaw, 50-981, Poland

Location

Hospital Germans Trias i Pujol

Badalona, Barcelona, 08916, Spain

Location

Hospital Clinico Universitario Virgen de la Arrixaca

El Palmar, Murcia, 30120, Spain

Location

Hospital Abente y Lago (Complejo Universitario de la Coruña)

A Coruña, 15001, Spain

Location

Hospital de la Santa Creu i Sant Pau Barcelona

Barcelona, 08041, Spain

Location

Hospital Universitario Reina Sofia

Córdoba, 14004, Spain

Location

Hospital Universitario Virgen Macarena

Seville, 41009, Spain

Location

Hospital Clinico Universitario de Valencia

Valencia, 46010, Spain

Location

Ninewells Hospital & Medical School

Dundee, DD1 9SY, United Kingdom

Location

CPS Research

Glasgow, G20 0XA, United Kingdom

Location

Glenfield hospital

Leicester, LE3 9QP, United Kingdom

Location

Barts and The London School of Medicine & Dentistry

London, EC1M 6BQ, United Kingdom

Location

Wythenshawe Hospital

Manchester, M23 9Lt, United Kingdom

Location

Related Publications (8)

  • Blumer V, Januzzi JL Jr, Liu Y, Butler J, Ezekowitz JA, Perfetti R, Rosenstock J, Del Prato S, Tang WHW, Urbinati A, Zannad F, Lewis GD, Solomon SD, Hedge S, Ibrahim NE, Lam CSP. Sex Differences in Diabetic Cardiomyopathy and Treatment Response to AT-001: Insights From the ARISE-HF Study. JACC Heart Fail. 2025 May 8:102433. doi: 10.1016/j.jchf.2025.02.015. Online ahead of print.

  • Siddiqi TJ, Liu Y, Zannad F, Tang WHW, Solomon S, Rosenstock J, Perfetti R, Marwick TH, Lewis GD, Lam CSP, Ibrahim NE, Ezekowitz J, Del Prato S, Butler J, Januzzi JL. Health status in stage B heart failure from diabetic cardiomyopathy baseline results from ARISE-HF. J Diabetes Complications. 2025 Jul;39(7):109059. doi: 10.1016/j.jdiacomp.2025.109059. Epub 2025 Apr 25.

  • Tang WHW, Liu Y, Butler J, Del Prato S, Ezekowitz JA, Ibrahim NE, Lam CSP, Marwick TH, Perfetti R, Rosenstock J, Solomon SD, Zannad F, Januzzi JL, Lewis GD. Impaired Exercise Capacity in High-Risk Diabetic Cardiomyopathy: The ARISE-HF Cardiopulmonary Exercise Testing Subanalysis. Circ Heart Fail. 2025 Mar;18(3):e012200. doi: 10.1161/CIRCHEARTFAILURE.124.012200. Epub 2025 Jan 30.

  • Marwick TH, Lam C, Liu Y, Del Prato S, Rosenstock J, Butler J, Ezekowitz J, Ibrahim NE, Tang WHW, Zannad F, Perfetti R, Januzzi JL. Echocardiographic phenotypes of diabetic myocardial disorder: evolution over 15 months follow-up in the ARISE-HF trial. Cardiovasc Diabetol. 2025 Jan 13;24(1):16. doi: 10.1186/s12933-024-02554-y.

  • Gouda P, Liu Y, Butler J, Del Prato S, Ibrahim NE, Lam CSP, Marwick T, Rosenstock J, Tang W, Zannad F, Januzzi J, Ezekowitz J. Relationship between NT-proBNP, echocardiographic abnormalities and functional status in patients with subclinical siabetic cardiomyopathy. Cardiovasc Diabetol. 2024 Aug 2;23(1):281. doi: 10.1186/s12933-024-02378-w.

  • Lopez J, Liu Y, Butler J, Del Prato S, Ezekowitz JA, Lam CSP, Marwick TH, Rosenstock J, Tang WHW, Perfetti R, Urbinati A, Zannad F, Januzzi JL Jr, Ibrahim NE. Racial Differences in Diabetic Cardiomyopathy: The ARISE-HF Trial. J Am Coll Cardiol. 2024 Jul 16;84(3):233-243. doi: 10.1016/j.jacc.2024.04.053.

  • Januzzi JL Jr, Butler J, Del Prato S, Ezekowitz JA, Ibrahim NE, Lam CSP, Lewis GD, Marwick TH, Perfetti R, Rosenstock J, Solomon SD, Tang WHW, Zannad F. Randomized Trial of a Selective Aldose Reductase Inhibitor in Patients With Diabetic Cardiomyopathy. J Am Coll Cardiol. 2024 Jul 9;84(2):137-148. doi: 10.1016/j.jacc.2024.03.380. Epub 2024 Apr 8.

  • Januzzi JL, Del Prato S, Rosenstock J, Butler J, Ezekowitz J, Ibrahim NE, Lam CSP, Marwick T, Wilson Tang WH, Liu Y, Mohebi R, Urbinati A, Zannad F, Perfetti R. Characterizing diabetic cardiomyopathy: baseline results from the ARISE-HF trial. Cardiovasc Diabetol. 2024 Feb 1;23(1):49. doi: 10.1186/s12933-024-02135-z.

MeSH Terms

Conditions

Diabetic CardiomyopathiesDiabetes Mellitus, Type 2

Interventions

caficrestat

Condition Hierarchy (Ancestors)

CardiomyopathiesHeart DiseasesCardiovascular DiseasesDiabetes ComplicationsDiabetes MellitusEndocrine System DiseasesGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic Diseases

Study Officials

  • James L Januzzi, MD

    Harvard Medical School (HMS and HSDM)

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 23, 2019

First Posted

September 10, 2019

Study Start

September 20, 2019

Primary Completion

December 1, 2023

Study Completion

December 1, 2025

Last Updated

December 8, 2022

Record last verified: 2022-12

Locations