Lysine Chloride for Heart Failure

Overseen By Jeffrey M Testani

Age: 18+

Sex: Any

Trial Phase: Phase < 1

Sponsor: Yale University

Must be taking: Beta blockers, ACE/ARB, Aldosterone antagonists, Loop diuretics

Must not be taking: Thiazide diuretics, Metformin

Disqualifiers: Acidosis, Renal failure, Anemia, others

Approved in 4 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 5 days

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the effects of lysine chloride, a sodium-free chloride supplement, on patients with stable heart failure. Researchers aim to understand its impact on electrolyte balance and overall fluid levels in the body. Participants will receive either lysine chloride or a placebo three times a day for five days. The trial seeks individuals with heart failure who have not been hospitalized in the past 90 days, are on stable medication, and have a low serum chloride level. As an Early Phase 1 trial, this research focuses on understanding how the treatment works in people, offering participants a chance to be among the first to receive this new treatment.

Will I have to stop taking my current medications?

The trial requires that you stay on your current heart failure medications, but you may need to stop taking metformin during certain parts of the study. If you are using a thiazide diuretic or certain chloride-containing medications, you may need to stop those as well.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that lysine chloride is generally safe for humans. Studies have found that ʟ-lysine hydrochloride, similar to lysine chloride, is well-tolerated by people. It has been used in dietary supplements at doses up to 3.75 grams per day without causing major side effects. Additionally, taking lysine supplements usually does not lead to many negative effects. This suggests that lysine chloride might be safe to use. However, since this trial is in an early stage, researchers are closely monitoring it to ensure safety. ^{1 2 3 4 5}

Why do researchers think this study treatment might be promising for heart failure?

Lysine chloride is unique because it offers a new approach to treating heart failure by potentially impacting blood volume management. Unlike the standard treatments, which often focus on improving heart function or reducing symptoms through medications like beta-blockers and ACE inhibitors, lysine chloride might work by directly influencing the body's fluid balance. Researchers are excited about this treatment because it could provide a quicker, more effective way to relieve symptoms of heart failure, with patients possibly seeing benefits within just days of starting therapy. If successful, this could represent a significant advancement in managing heart failure, offering hope to patients who need faster relief.

What evidence suggests that lysine chloride might be an effective treatment for heart failure?

This trial will compare Lysine Chloride with a placebo to evaluate its effects on heart failure. Research has shown that lysine supplements may benefit heart health. One study found that lysine improved the heart and blood vessels' ability to handle stress, suggesting it could support heart health by managing stress. Lysine is also safe for consumption, even in larger amounts. While this trial continues to investigate Lysine Chloride for heart failure, these early findings are promising and suggest it might help improve heart function. ^{1 2 6 7 8}

Who Is on the Research Team?

Jeffrey M Testani, MD

Principal Investigator

Yale University

Are You a Good Fit for This Trial?

This trial is for stable heart failure patients with an ejection fraction below 40%, on chronic loop diuretic therapy, and a serum chloride level under 102 mmol/L. They must have no hospitalizations in the past 90 days, be on evidence-based treatments, and have a history of following medical advice. Exclusions include those unable to follow the study protocol, using certain medications like metformin or thiazide diuretics recently, with severe kidney issues or significant blood sugar problems.

Inclusion Criteria

My heart failure is stable, with no hospital visits in 3 months, and I'm on a strict medication regimen.

Meticulous history of medical compliance and attendance of appointments

Exclusion Criteria

I have taken a water pill in the last month.

My hemoglobin level is below 8.0 g/dL.

I am not taking medications like metformin that could cause acidosis, or I can stop metformin safely for the study.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive lysine chloride or placebo twice a day for 5 days after a blood volume assessment

5 days

Daily visits (inpatient)

Follow-up

Participants are monitored for changes in blood volume, NTpro-BNP, chloride, serum creatinine, cystatin C, and bicarbonate

7 days

Daily monitoring (inpatient)

What Are the Treatments Tested in This Trial?

Interventions

• Lysine Chloride
• Placebo

Trial Overview The trial is testing how sodium-free chloride supplementation (Lysine Chloride) affects electrolyte balance and fluid status compared to a placebo in heart failure patients. The goal is to understand if manipulating chloride levels can improve heart function by studying changes in volume status and sodium retention.

How Is the Trial Designed?

Group I: Lysine Chloride Experimental Treatment 1 Intervention

Patients will be randomized to receive either lysine chloride or placebo. Patients will receive the study drug thrice daily for 5 days of randomized therapy, starting after the completion of a blood volume assessment.

Group II: Placebo Placebo Group 1 Intervention

Patients will be randomized to receive either lysine chloride or placebo. Patients will receive the study drug thrice daily for 5 days of randomized therapy, starting after the completion of a blood volume assessment.

Lysine Chloride is already approved in United States, European Union, Japan, India for the following indications:

Approved in United States as Lysine Hydrochloride for:

• Herpes simplex prophylaxis and treatment
• Lysinuric protein intolerance
• Nephroprotection

Approved in European Union as Lysine Hydrochloride for:

• Herpes simplex prophylaxis and treatment
• Lysinuric protein intolerance
• Nephroprotection
• Schizophrenia

Approved in Japan as Lysine Hydrochloride for:

• Herpes simplex prophylaxis and treatment
• Anxiety

Approved in India as Lysine Hydrochloride for:

• Herpes simplex prophylaxis and treatment
• Lysinuric protein intolerance
• Nephroprotection
• Schizophrenia
• Muscle recovery

Who Is Running the Clinical Trial?

Yale University

Lead Sponsor

Trials

1,963

Recruited

3,046,000+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

Published Research Related to This Trial

l-Lysine monohydrochloride and l-lysine sulfate produced by Corynebacterium glutamicum CGMCC 7.266 are considered safe for animals, consumers, and the environment, with no safety concerns related to the genetic modification of the production strain.

Both forms of l-lysine are effective nutritional additives for all animal species, but they need protection against degradation in the rumen to be as effective in ruminants as they are in non-ruminants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety and efficacy of l-lysine monohydrochloride and l-lysine sulfate produced using Corynebacterium glutamicum CGMCC 7.266 for all animal species. Bampidis, V., Azimonti, G., Bastos, ML., et al.[2020]

L-lysine monohydrochloride (LMH) is primarily used as a nonprescription supplement to help suppress recurrent herpes simplex infections, indicating its efficacy in managing this viral condition.

Recent studies suggest that LMH may have potential therapeutic uses beyond herpes, including applications in cardiovascular disease and osteoporosis, warranting further research into its broader health benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The metabolic roles, pharmacology, and toxicology of lysine. Flodin, NW.[2019]

Concentrated liquid l-lysine and l-lysine HCl produced from the genetically modified strain Corynebacterium casei KCCM 80190 are safe for use in animal feed, as they do not pose risks to animals, consumers, or the environment, and no harmful genetic modifications were detected in the final products.

While both forms of l-lysine are effective for non-ruminant animals, additional protection would be needed for ruminants to ensure the l-lysine remains effective in their digestive systems.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety and efficacy of concentrated liquid l-lysine (base) and l-lysine monohydrochloride produced by fermentation with Corynebacterium casei KCCM 80190 as feed additives for all animal species. Bampidis, V., Azimonti, G., Bastos, ML., et al.[2023]

The use of l-lysine monohydrochloride and l-lysine sulfate produced by the genetically modified strain C. glutamicum CGMCC 17927 is safe for all animal species and does not pose safety concerns regarding the production strain, as no viable cells or recombinant DNA were found in the final products.

Both forms of l-lysine are effective nutritional additives for non-ruminant animals, but for ruminants, additional protection against degradation in the rumen is necessary to ensure efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety and efficacy of a feed additive consisting of l-lysine monohydrochloride and l-lysine sulfate produced by fermentation with Corynebacterium glutamicumCGMCC 17927 for all animal species (Barentz Animal Nutrition B.V.). Bampidis, V., Azimonti, G., de Lourdes Bastos, M., et al.[2022]

L-lysine monohydrochloride and l-lysine sulfate produced by Corynebacterium glutamicum CGMCC 14498 are considered safe for all animal species and do not pose safety concerns for consumers or the environment.

These forms of l-lysine are effective nutritional feed additives for non-ruminant animals, but additional protection would be needed for their efficacy in ruminants due to potential degradation in the rumen.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety and efficacy of a feed additive consisting of l-lysine monohydrochloride and l-lysine sulfate produced by Corynebacterium glutamicum CGMCC 14498 for all animal species (Kempex Holland BV). Bampidis, V., Azimonti, G., Bastos, ML., et al.[2022]

Citations

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Lysine Uses, Benefits & Dosage Lysine has been investigated for its effects on increasing muscle mass, improving glucose metabolism and associated toxic glycated byproducts, ...

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The effect of multiple micronutrient supplementation on ... A high dose of multiple micronutrients may have beneficial effects on cardiac function in patients with symptomatic heart failure.

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Effect of lysine supplementation on cardiovascular ... Conclusion: There were positive effects of lysine supplementation on the outcomes of cardiovascular response to stressors by normalizing and reducing the stress ...

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Comprehensive Safety Assessment of ʟ-Lysine ... ʟ-lysine hydrochloride was a safe and well-tolerated substance in humans using doses in dietary supplements up to 3.0 g/d (3.75 g/d as ʟ-lysine hydrochloride).

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Comprehensive Safety Assessment of L-Lysine ... The outcome data were incomplete in 11 studies. Review of ... Hypochloremia and diuretic resistance in heart failure: mechanistic insights.

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Lysine - Uses, Side Effects, and More Learn more about Lysine uses, effectiveness, possible side effects, interactions, dosage, user ratings and products that contain Lysine.

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Lysine health benefits: Evidence and food sources Taking lysine supplements is very safe and does not seem to cause many side effects. ... Anxiolytic, anti-nociceptive and body weight reducing effects of L-lysine ...

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Lysine Hydrochloride Lysine hydrochloride (Lysine HCl ... PRRT improved survival in patients with neuroendocrine neoplasm and carcinoid heart disease treated surgically in a centre of ...