Actively Recruiting
Comparative Efficacy and Safety of Acetazolamide Versus Metolazone as an Adjunct to Standard Therapy in Patients With Acute Decompensated Heart Failure
Led by University of Health Sciences Lahore · Updated on 2025-10-03
320
Participants Needed
1
Research Sites
2 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are evaluating the effectiveness and safety of acetazolamide versus metolazone when added to standard treatment in patients with acute decompensated heart failure (ADHF). This condition is serious and often treated with loop diuretics to reduce excess fluid. The study aims to determine which adjunct therapy better improves fluid removal, shortens hospital stays, and reduces complications like kidney problems or electrolyte imbalances. The trial is focused on patients with ADHF, including those with preserved or reduced heart function. Participants will be randomly assigned to receive either acetazolamide at 500 mg daily or metolazone at 5 mg daily, both alongside standard intravenous loop diuretics (furosemide 80 mg per day). These treatments are given orally for three days to assess their role in enhancing fluid removal. The trial compares these two adjunct therapies to see which is more effective and safe in managing fluid overload in ADHF. During the study, patients will be closely monitored for successful fluid removal after 72 hours of treatment, along with hospital stay duration and in-hospital mortality. Researchers will also watch kidney function, electrolyte levels, and any side effects. The study takes place at a hospital setting and involves routine clinical assessments, imaging to confirm fluid overload, and blood tests to measure heart failure markers. Total participation duration covers the initial treatment and hospital stay.
CONDITIONS
Brief Title
Comparative Efficacy and Safety of Acetazolamide Versus Metolazone as an Adjunct to Standard Therapy in Patients With Acute Decompensated Heart Failure
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Aged 18 years or older
- Diagnosed with acute decompensated heart failure with preserved or reduced ejection fraction
- At least one clinical sign of volume overload such as pleural effusion confirmed by chest X-ray or ultrasound
- Presence of oedema or ascites verified by abdominal ultrasonography
- Plasma NT-proBNP level greater than 1000 pg/mL or BNP level greater than 250 ng/mL at screening
- Receiving at least 40 mg of furosemide as oral maintenance therapy for at least one month before study start
You will not qualify if you...
- Previous use of acetazolamide or metolazone before the study period
- Known allergies to acetazolamide, metolazone, or their components
- Presence of electrolyte disturbances, especially low potassium levels (hypokalemia)
- End-stage kidney disease requiring dialysis or glomerular filtration rate below 20 mL/min/1.73 m2
- Pregnant or breastfeeding women
- Severe low blood pressure (systolic below 90 mmHg) or serious heart conditions requiring surgery
- Need for kidney replacement therapy during hospitalization
- History of significant electrolyte or acid-base imbalances
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - 3 days
Participants receive either acetazolamide or metolazone daily as an adjunct to standard heart failure therapy including intravenous loop diuretics to improve decongestion.
Daily administration during hospitalization with monitoring visits
Trial Site Locations
Total: 1 location
1
Quaid e Azam Medical College , bahawalpur
Chak Four Hundred Fifty-four, Punjab Province, Pakistan
Actively Recruiting
Research Team
M
Matiullah Azmoon
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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