TRED-HF2 is a research study which aims to investigate the therapies that are required to maintain remission of dilated cardiomyopathy. Remission of dilated cardiomyopathy occurs when the heart function improves and symptoms of heart failure have resolved.
Our previous study, TRED-HF, suggested that at least some medications were needed to maintain remission in the majority of people. This study will investigate the medications that may be most important. It builds on discussion that we have had with patients and builds on their desire to tailor therapy and improve quality of life.
We are looking to recruit patients with:
- a previous diagnosis of dilated cardiomyopathy
- who have improved cardiac function and feel well
- and are taking 3 or 4 heart failure medications, including
- a beta-blocker (such as bisoprolol or carvedilol)
and - an ACE inhibitor or ARB (such as rampiril or sacubitril/valsartan)
and at least one of the following: - an SGLT2 inhibitor (like dapagliflozin or empagliflozin)
or - a mineralocorticoid receptor antagonist (like spironolactone or eplerenone).
- a beta-blocker (such as bisoprolol or carvedilol)
Our trial will investigate whether it is safe and feasible for patients to stop an SGLT2 inhibitor and/or a mineralocorticoid receptor antagonist if they continue a beta-blocker and ACE inhibitor or ARB.
We plan to withdraw the medications gradually over 16 weeks and use heart (MRI) scans and blood tests to carefully monitor heart function. If there are any early signs of a reduction in heart function we will re-establish patients on medication immediately.
The study will take place over 8 months. Patients will be closely monitored by a team of doctors and nurses. Initially, only half of the patients will have medication withdrawn so we have a control group. After 4 months, the remaining patients will be offered a trial of stopping their medications.
There will be visits to the hospital every 1-2 months for the 8 months of the study for all participants. We will reimburse reasonable travel expenses.
If you would like to know more, even if you’re not sure you want to get involved, please contact us via one of the methods below and one of our researchers will be pleased to discuss the project in more detail.
Email: tred2trial@imperial.ac.uk