Phase III Study Investigating Heart Failure and Cardiovascular Death With Baxdrostat in Combination With Dapagliflozin

Summary

Participants include men and women ≥ 40 years of age with T2DM, established CV disease, a history of HTN with an SBP of at least 130 mmHg at screening, who meet the predefined serum potassium level, and with at least one additional risk factor for HF. The study will include an optional pre-screening period to facilitate sites' identification of potentially eligible participants to enter the full screening assessments. Participants will not be required to visit the site and no informed consent is required for the optional pre-screening period. The pre-screening assessments do not replace the full screening tests at Visit 1. Upon entering the screening period, all consented participants (after signature of screening ICF) will be screened during an up to 14-day screening period. Participants who meet all screening inclusion/exclusion criteria but are not treated with SGLT2i or are treated for less than 4 weeks will enter a run-in period with dapagliflozin 10 mg once daily for at least 4 weeks (and not more than 6 weeks) before randomisation. Site visits will take place at approximately 2-, 4-, 8-, 16-, and 34-weeks following randomisation. Thereafter visits will occur approximately every 4 months. The study closure procedures will be initiated when the predetermined number of the first secondary endpoint events (ie, the composite of hospitalisation for HF or CV death) is predicted to have occurred i.e., the PACD. In case of premature discontinuation of the blinded study intervention, participants will remain in the study. Unless a participant meets the dapagliflozin specific discontinuation criteria, they will continue to receive open label dapagliflozin 10 mg. It is important that the scheduled study visits and data collection continue according to the study protocol.

Eligibility

Study design

Outcome measures

1. Primary outcome

   To determine if baxdrostat/dapagliflozin is superior to placebo/dapagliflozin in reducing the risk of an HF event or CV death

   Time to first occurrence of any of the components of the composite of: * Hospitalisation for HF * HF without hospitalisation * CV death

   Time frame Event driven; Up to 38 months

2. Secondary outcome

   To determine whether baxdrostat/dapagliflozin is superior to placebo/dapagliflozin in reducing the risk of hospitalisation for HF or CV death

   Time to first occurrence of any of the components of the composite of: * Hospitalisation for HF * CV death

   Time frame Event driven; Up to 38 months

3. Secondary outcome

   To determine whether baxdrostat/dapagliflozin is superior to placebo/dapagliflozin in reducing the risk of HF events

   Time to first occurrence of any of the components of the composite of: * Hospitalisation for HF * HF without hospitalisation

   Time frame Event driven; Up to 38 months

4. Secondary outcome

   To determine whether baxdrostat/dapagliflozin is superior to placebo/dapagliflozin in reducing the risk of CV death

   Time to CV death

   Time frame Event driven; Up to 38 months

5. Secondary outcome

   To determine whether baxdrostat/dapagliflozin is superior to placebo/dapagliflozin in reducing the risk of all-cause mortality

   Time to all-cause death

   Time frame Event driven; Up to 38 months

6. Secondary outcome

   To determine whether baxdrostat/dapagliflozin is superior to placebo/dapagliflozin in reducing the risk of 4-point MACE (CV death, MI, stroke, and hospitalisation for HF)

   Time to first occurrence of any of the components of the composite of: * CV death * MI * Stroke * Hospitalisation for HF

   Time frame Event driven; Up to 38 months

Dates

Actual means the event happened. Estimated means the sponsor expects it. The two mean different things.

Locations

830 sites are recruiting

907 further sites are listed in the registry record.

Study documents

No documents are linked in this registry record.

Changes over time

1. September 15, 2026

   Site added

   4 sites added (957 total)

   953 → 957

2. July 31, 2026

   Site added

   11 sites added (953 total)

   942 → 953