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The availability of Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) has dramatically altered the management of heart failure (HF) patients, independently of their ejection fraction and glycemic status. A meta-analysis of 57 studies comparing SGLT2-I monotherapy vs. placebo or active comparator showed reductions in major cardiovascular events, but no impact on atherothrombotic events. In fact, a non-significant increase in the risk for non-fatal stroke was observed. Similar trend observed in multiple trials indicate a SGLT2-i class effect. Sotagliflozin is the first dual SGLT1/2 receptor inhibitor, that was shown to significantly reduce atherothrombotic events compared with placebo in diabetic HF patients, suggesting that dual SGLT1/2 inhibitor may have additional properties vs. SGLT2-i. The hypothesis of this study is that dual SGLT1/2 inhibition by sotagliflozin improves thrombogenic profile (i.e. reduces thrombus formation), which could make it a safer and more effective treatment option for cardiovascular (CV) patients than SGLT2-i. To test the hypothesis, the researchers will compare the antithrombotic activity of sotagliflozin vs. empagliflozin in healthy volunteers using a randomized, cross-over study design, where each participant will receive both study treatments (sotagliflozin and empagliflozin) separated by a washout period. Treatment effects will be assessed by measuring ex vivo thrombus formation using the Badimon Perfusion chamber, platelet aggregation using Multiplate Analyzer, and Thromboelastometry using RoTEM Gamma. Study assessments will be performed before initiating (baseline/pre-treatment) and after completion of each treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sotagliflozin then Empagliflozin | Other | Subjects randomized to 'Arm A' will receive 1-month of 'Sotagliflozin' treatment first and then 1-month of 'Empagliflozin' treatment second, separated by a 1-month of washout period. |
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| Empagliflozin then Sotagliflozin | Other | Subjects randomized to 'Arm B' will receive1-month of 'Empagliflozin' treatment first and then1-month of 'Sotagliflozin' treatment second, separated by a 1-month of washout peri od |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sotagliflozin | Drug | Sotagliflozin 400 mg, P.O. once daily for 1 month. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Thrombus size | Changes in blood thrombogenicity (thrombus size) from baseline to post-treatment | Baseline and end of each treatment period (1 month and 3 months) |
| Measure | Description | Time Frame |
|---|---|---|
| Platelet aggregation | A platelet aggregation is a blood test that looks at the reactivity of platelets. | Baseline and end of each treatment period (1 month and 3 months) |
| Clot formation size | The size of the clot will be assessed in whole blood samples using a thromboelastometry |
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Inclusion Criteria:
Subjects are eligible if they meet all of the following criteria:
Exclusion criteria:
Subjects will be excluded if they meet any of the following criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Juan J Badimon | Icahn School of Medicine at Mount Sinai | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Icahn School of Medicine at Mount Sinai | New York | New York | 10029 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40748666 | Derived | Requena-Ibanez JA, Zafar MU, Ferrandez-Escarabajal M, Escolar G, Santos-Gallego C, Lam D, Badimon JJ. Rationale and Design of the SOTA-THROMBOSIS Trial (ATRU-VI): Antithrombotic Activities of Sotagliflozin Compared With Empagliflozin. J Cardiovasc Pharmacol. 2025 Nov 1;86(5):458-462. doi: 10.1097/FJC.0000000000001747. |
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| ID | Term |
|---|---|
| D013927 | Thrombosis |
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D006331 | Heart Diseases |
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| ID | Term |
|---|---|
| C575681 | (2S,3R,4R,5S,6R)-2-(4-chloro-3-(4-ethoxybenzyl)phenyl)-6-(methylthio)tetrahydro-2H-pyran-3,4,5-triol |
| C570240 | empagliflozin |
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| Empagliflozin | Drug | Empagliflozin 10 mg, P.O. once daily for 1 month. |
|
| Baseline and end of each treatment period (1 month and 3 months) |