Triple Combination Therapy (ARNI, SGLT2i, MRA) in Advanced HFpEF

Summary

Patients with advanced heart failure with preserved ejection fraction (HFpEF) will be randomly assigned in open-label multicenter study to receive triple combination therapy with \[angiotensin receptor/neprilysin inhibitor \[ARNI\] + sodium-glucose cotransporter 2 inhibitor \[SGLTi\] + mineralocorticoid receptor antagonist \[MRA\]) or with individualized medical therapy \[SGLTi + renin-angiotensin system inhibitor \[RASi\] \[angiotensin receptor blocker \[ARB\] or angiotensin-converting enzyme inhibitor \[ACE-I\]), and will be treated for 52 weeks

Timeline

Start

2025-03-18

Primary completion

2027-12-31

Completion

2027-12-31

Publications

• Muhammad Daniyal S, Ajaz H, Riaz M, Murad Khatoon N, Aftab Z, Tauqir Gondal H, Gul I, Sarwar M, Batool F, Fahim SL, Noor A, Khalid A, Ashraf DA, Jabarkhil R. Combination therapy with mineralocorticoid receptor antagonists and SGLT2 inhibitors versus SGLT2 inhibitor monotherapy in chronic kidney disease: an updated meta-analysis of randomized controlled trials. BMC Nephrol. 2025 Dec 22;27(1):69. doi: 10.1186/s12882-025-04710-2.

Drugs

Indications