RecruitingNot ApplicableNCT07199088

Comparative Efficacy and Safety of Acetazolamide Versus Metolazone as an Adjunct to Standard Therapy in Patients With Acute Decompensated Heart Failure

Sponsor

University of Health Sciences Lahore

Enrollment

320 participants

Start Date

Oct 11, 2025

Study Type

INTERVENTIONAL

Conditions

Heart Failure, Diastolic Acute Decompensated Heart Failure Heart Failure, Systolic

Summary

This clinical trial aims to compare the efficacy and safety of acetazolamide versus metolazone as adjunctive treatments to standard therapy in patients with acute decompensated heart failure (ADHF). ADHF is a life-threatening condition, and current treatments often involve loop diuretics to alleviate volume overload. This study will assess the added benefit of acetazolamide and metolazone in improving decongestion, reducing hospital stays, and preventing complications such as renal dysfunction or electrolyte imbalances. Participants will be randomized to receive either acetazolamide or metolazone in addition to standard diuretic therapy. The trial will evaluate primary outcomes including successful decongestion, in-hospital mortality, and length of hospital stay, with secondary outcomes focusing on renal function, electrolyte disturbances, and overall safety. The study is conducted at Bahawal Victoria Hospital, Bahawalpur, and aims to provide valuable insights into the management of ADHF, especially in the Pakistani population.

Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is comparing two medications — acetazolamide and metolazone — as add-on treatments for patients hospitalized with sudden worsening of heart failure (acute decompensated heart failure). Both drugs help the kidneys remove excess fluid, and researchers want to find out which works better alongside standard diuretic therapy. **You may be eligible if...** - You are 18 or older and admitted to hospital for worsening heart failure - You have signs of excess fluid buildup (such as leg swelling, fluid in the lungs, or elevated heart failure blood markers) - You have been taking at least 40 mg of furosemide (a water pill) daily for at least one month **You may NOT be eligible if...** - You have previously used acetazolamide or metolazone - You are allergic to either study drug - You have dangerous electrolyte imbalances - You have certain kidney or metabolic conditions that make these drugs unsafe Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

OTHERAcetazolamide

A carbonic anhydrase inhibitor, 500 mg orally once a day as an adjunct to loop diuretics for enhancing diuresis and improving decongestion in ADHF patients.

OTHERMetolazone

A thiazide-like diuretic, 5 mg orally once a day as an adjunct to loop diuretics for enhancing diuresis and improving decongestion in ADHF patients.