NCT07737964

Brief Summary

Acute congestion is common in patients with heart failure (HF) and is associated with impaired renal function, reduced quality of life, hospital readmissions, and mortality. Current guidelines recommend optimal decongestion using diuretic therapy, mainly loop diuretics. Although acetazolamide has recently demonstrated efficacy in hospitalized patients, its role in ambulatory patients managed through remote telemonitoring remains to be established. This study aims to evaluate the efficacy of oral acetazolamide added to conventional treatment for decongesting ambulatory HF patients during congestive decompensations. ACHIEVE is a Phase III multicenter, prospective, interventional, randomized, controlled, open-label superiority trial evaluating the efficacy of oral acetazolamide added to conventional treatment for decongestion in ambulatory patients with heart failure during congestive decompensation monitored by remote telemonitoring. The primary objective is to assess, at Day 5, whether acetazolamide added to conventional treatment improves decongestion compared with standard treatment alone. Secondary objectives include evaluating efficacy, safety, and health economic outcomes, including quality of life, dyspnea, biological markers, unplanned consultations, hospitalizations, mortality, and hospital medical costs.

Trial Health

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Trial Health Score

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

Enrollment
366

participants targeted

Target at P50-P75 for phase_3 heart-failure

Timeline
27mo left

Started Oct 2026

Geographic Reach
1 country

25 active sites

Status
not yet 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

July 27, 2026

Completed
3 days until next milestone

First Posted

Study publicly available on registry

July 30, 2026

Completed
2 months until next milestone

Study Start

First participant enrolled

October 1, 2026

Expected
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2029

Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2029

Last Updated

July 30, 2026

Status Verified

July 1, 2026

Enrollment Period

2.3 years

First QC Date

July 27, 2026

Last Update Submit

July 27, 2026

Conditions

Keywords

heart failurecongestionambulatory treatmentremote telemonitoringdiuretics

Outcome Measures

Primary Outcomes (1)

  • Percentage of participants with weight loss >2 kg at Day

    Percentage of participants who achieve a body weight loss greater than 2 kg between baseline (Day 0) and Day 5, measured using a connected scale through the remote telemonitoring system. Comparison between the experimental and control groups.

    Day 5

Secondary Outcomes (22)

  • Efficacy : Percentage of weight variation

    Day 0 to Day 5

  • Efficacy : Diuretic effectiveness

    Day 5

  • Efficacy : Change in NT-proBNP concentration

    Day 0 to Day 5

  • Efficacy : Change in health-related quality of life (EQ-5D-5L)

    Day 0 to Day 5

  • Efficacy : Change in dyspnea Visual Analogue Scale (VAS) score

    Day 0 to Day 5

  • +17 more secondary outcomes

Study Arms (2)

Experimental group - Acetazolamide

EXPERIMENTAL

Ambulatory patients with decompensated heart failure receiving standard treatment with loop diuretics (furosemide) plus oral acetazolamide for up to 5 days. Treatment effectiveness and safety are assessed daily using remote telemonitoring data.

Drug: Acetazolamide and furosemide

Control group - Standard treatment

ACTIVE COMPARATOR

Ambulatory patients with decompensated heart failure receiving standard treatment with loop diuretics (furosemide) alone for up to 5 days. Treatment effectiveness and safety are assessed daily using remote telemonitoring data.

Drug: Furosemide

Interventions

Oral acetazolamide initiated at 500 mg (2 tablets) on Day 0 in addition to standard treatment with loop diuretics. The dose may be adjusted every 48 hours according to the participant's clinical status until Day 5, if necessary.

Experimental group - Acetazolamide

Standard treatment with loop diuretics (furosemide) administered for up to 5 days according to standard clinical practice.

Control group - Standard treatment

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age ≥ 18
  • Known HF with impaired, midly-reduced or preserved LVEF
  • Previously followed (or included at hospital discharge) by remote monitoring allowing daily weight by connected scale (i.e. Careline®, Optified-self®, NewCard®, Implicity®)
  • Current unplanned hospitalization or unplanned/emergent consultation for acute/decompensation HF

You may not qualify if:

  • Subject unable to express their consent and sign informed consent form
  • Subject not covered by public health insurance
  • Refusal to participate (absence of informed consent).
  • Subject under guardianship, legal protection, or deprived of liberty.
  • Pregnant or breastfeeding women.
  • Subject under law protection and prisoners
  • Women of child bearing potential, unless they are using an effective method of birth control (i.e. oral contraceptives, implantable contraceptives, injectable contraceptives, transdermal contraceptives, intrauterine devices, male or female condoms with spermicide, abstinence, or a sterile sexual partner)
  • Subject unable to comprehend or adhere to the protocol and follow-up
  • Concurrent participation in another interventional study.
  • Chronic ventricular assist device or heart transplant patients.
  • Acute heart failure from recent acute coronary syndrome (\< 1 month).
  • Severe chronic renal failure or dialysis (GFR \< 20 ml/min).
  • History of renal colic, hyperchloremic acidosis and wheat allergy (other than coeliac disease)
  • Known severe hepatic insufficiency defined by a PTT \< 50% or a Child-Pugh score C and/or a known (clinial or biological) supplemented adrenal insufficiency
  • Intolerance to sulphonamides
  • +13 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (25)

University Hospital Amiens-Picardie

Amiens, France

Location

University Hospital Angers

Angers, France

Location

Avignon Hospital

Avignon, France

Location

University Hospital Besançon

Besançon, France

Location

Hospital Beziers

Béziers, France

Location

University Hospital Bordeaux

Bordeaux, France

Location

University Hospital Brest

Brest, France

Location

University Hospital Caen

Caen, France

Location

Chartres Hospital

Chartres, France

Location

Cholet Hospital

Cholet, France

Location

Sud Francilien Hospital

Corbeil-Essonnes, France

Location

Dreux Hospital

Dreux, France

Location

Cardiovascular Institute - Grenoble Mutualist Hospital Group

Grenoble, France

Location

University Hospital Grenoble Alpes

Grenoble, France

Location

Bicêtre Hospital

Le Kremlin-Bicêtre, France

Location

Pôle Santé Sud - Le Mans

Le Mans, France

Location

Louis Pradel Hospital

Lyon, France

Location

University hospital Montpellier

Montpellier, France

Location

Regional University Hospital Nancy

Nancy, France

Location

The Confluent Private Hospital

Nantes, France

Location

University Hospital Nîmes

Nîmes, France

Location

Ellipse Center Strasbourg

Strasbourg, France

Location

Sainte Musse Hospital Toulon

Toulon, France

Location

University Hospital Toulouse

Toulouse, France

Location

Valenciennes Hospital

Valenciennes, France

Location

MeSH Terms

Conditions

Heart Failure

Interventions

AcetazolamideFurosemide

Condition Hierarchy (Ancestors)

Heart DiseasesCardiovascular Diseases

Intervention Hierarchy (Ancestors)

ThiadiazolesThiazolesSulfur CompoundsOrganic ChemicalsAzolesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsSulfanilamidesSulfonamidesAmidesAniline CompoundsAminesSulfones

Study Officials

  • François ROUBILLE, MD

    University Hospital, Montpellier

    STUDY DIRECTOR

Central Study Contacts

François ROUBILLE, MD

CONTACT

Clément Delmas, MD

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: This multicenter, prospective, randomized, controlled, open-label, superiority Phase III trial compares two parallel groups: standard decongestion with loop diuretics (control group) versus standard decongestion plus oral acetazolamide (experimental group) in ambulatory patients with decompensated heart failure monitored by remote telemonitoring.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 27, 2026

First Posted

July 30, 2026

Study Start (Estimated)

October 1, 2026

Primary Completion (Estimated)

January 1, 2029

Study Completion (Estimated)

January 1, 2029

Last Updated

July 30, 2026

Record last verified: 2026-07

Locations