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Empagliflozin (Jardiance)® is a sodium glucose co-transporter 2 (SGLT2)-Inhibitor, which is a new treatment option developed for patients with diabetes mellitus type 2. The SGLT2 is expressed in the proximal tubule and reabsorbs approximately 90 percent of the filtered glucose. The inhibition of SGLT2 results in renal excretion of glucose with subsequent osmotic diuresis. This mechanism could result in a therapeutic effect in patients with hypotonic hyponatremia as in the syndrome of inappropriate antidiuretic hormone (ADH) secretion (SIAD). Because patients with SIAD usually have several comorbidities and different medications, studies investigating the physiological effects are difficult to interpret. Therefore a model to study the possible physiological effect of SGLT2-inhibitors in hypotonic hyponatremia as in SIAD is needed.
The aim of this study is to evaluate whether empagliflozin (Jardiance)® has an effect on serum sodium levels of healthy volunteers with induced hypotonic hyponatremia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Empagliflozin 25mg Tbl | Active Comparator | Induced hypotonic hyponatremia - SIAD model: Hypotonic hyponatremia will be induced in healthy volunteers through oral overhydration and parenteral administration of desmopressin (Minirin)® 4ug. After administration of the study drug, the artificial SIAD will be sustained with infusion of hypotonic sodium-solution (NaCl 0.45%) over two hours. |
|
| Placebo P-Tablet | Placebo Comparator | Induced hypotonic hyponatremia - SIAD model: Hypotonic hyponatremia will be induced in healthy volunteers through oral overhydration and parenteral administration of desmopressin (Minirin)® 4ug. After administration of the study drug, the artificial SIAD will be sustained with infusion of hypotonic sodium-solution (NaCl 0.45%) over two hours. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Induced hypotonic hyponatremia - SIAD model | Other |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| The primary outcome is the area under the curve (AUC) of the serum sodium concentration between time points 2 and 8 hours after administration of the study drug. | concentration measured every hour within 8 hours after drug administration on both study days |
| Measure | Description | Time Frame |
|---|---|---|
| Serum sodium concentration at every time point of the study | every hour for twelve hours on each of the two study days | |
| Amount of urinary excretion | every 2 hours for twelve hours on each of the two study days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mirjam Christ-Crain, Prof. | Deputy chief division endocrinology university hospital basel | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department Endocrinology University Hospital Basel | Basel | Basel | 4031 | Switzerland |
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| Empagliflozin 25mg Tbl | Drug |
|
| Placebo P-Tablet | Drug |
|
| Serum osmolality at every time point of the study | every hour for twelve hours on each of the two study days |
| Serum glucose at every time point of the study | every hour for twelve hours on each of the two study days |
| Urinary osmolality | every two hours for twelve hours on each of the two study days |
| Urinary glucose | every 2 hours for twelve hours on each of the two study days |
| Serum electrolytes at time point -1, 0, 2 and 8 | 1 hour before induction of siad, at baseline, 2 hours and 8 hours after administration of study medication on each study day |
| Urinary electrolytes at time point -1, 0, 2 and 8 | 1 hour before induction of siad, at baseline, 2 hours and 8 hours after administration of study medication on each study day |
| Plasma level of Copeptin at time point -1, 0, 2 and 8 | 1 hour before induction of siad, at baseline, 2 hours and 8 hours after administration of study medication on each study day |
| Plasma level of Aldosterone at time point -1, 0, 2 and 8 | 1 hour before induction of siad, at baseline, 2 hours and 8 hours after administration of study medication on each study day |
| Plasma level of Renin at time point -1, 0, 2 and 8 | 1 hour before induction of siad, at baseline, 2 hours and 8 hours after administration of study medication on each study day |
| Plasma Level of atrial natriuretic peptide (ANP) at time point -1, 0, 2 and 8 | 1 hour before induction of siad, at baseline, 2 hours and 8 hours after administration of study medication on each study day |
| Plasma levels of brain natriuretic peptide (BNP) at time point -1, 0, 2 and 8 | 1 hour before induction of siad, at baseline, 2 hours and 8 hours after administration of study medication on each study day |
| Body weight at every time point of the study | every hour during 12 hours on each of the two study days |
| Blood pressure at every time point of the study | every hour during 12 hours on each of the two study days |
| Heart rate at every time point of the study | every hour during 12 hours on each of the two study days |
| Symptoms of hyponatremia assessed by visual analogue scale (VAS) at every time point of the study | every hour during 12 hours on each of the two study days |
| Urinary sodium level | every 2 hours for twelve hours on each of the two study days |
| ID | Term |
|---|---|
| D007177 | Inappropriate ADH Syndrome |
| D007010 | Hyponatremia |
| ID | Term |
|---|---|
| D010900 | Pituitary Diseases |
| D007027 | Hypothalamic Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014883 | Water-Electrolyte Imbalance |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| C570240 | empagliflozin |
| D013607 | Tablets |
| ID | Term |
|---|---|
| D004304 | Dosage Forms |
| D004364 | Pharmaceutical Preparations |
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