| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
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| E.1.1.1 | Medical condition in easily understood language  | 
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| E.1.1.2 | Therapeutic area  | Diseases [C] - Cardiovascular Diseases [C14] | 
| MedDRA Classification | 
| E.1.2 Medical condition or disease under investigation | 
| E.1.2 | Version  | 20.0 | 
 
| E.1.2 | Level  | LLT | 
 
| E.1.2 | Classification code  | 10019279 | 
 
| E.1.2 | Term  | Heart failure | 
 
| E.1.2 | System Organ Class  | 100000004849 | 
 
 
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| E.1.2 Medical condition or disease under investigation | 
| E.1.2 | Version  | 21.1 | 
 
| E.1.2 | Level  | PT | 
 
| E.1.2 | Classification code  | 10067585 | 
 
| E.1.2 | Term  | Type 2 diabetes mellitus | 
 
| E.1.2 | System Organ Class  | 10027433 - Metabolism and nutrition disorders | 
 
 
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| E.1.3 | Condition being studied is a rare disease  |  No  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
-To demonstrate that sotagliflozin reduces cardiovascular (CV) mortality and morbidity (composite of CV death or hospitalization for heart failure [HHF])  compared to placebo in hemodynamically stable patients with type 2 diabetes (T2D) and heart failure (HF) with left ventricular ejection fraction(LVEF) <50%, after admission for worsening heart failure (WHF).
 -To demonstrate that sotagliflozin reduces cardiovascular (CV) mortality and morbidity (composite of CV death or hospitalization for heart failure [HHF]) compared to placebo in hemodynamically stable patients with T2D and HF irrespective of LVEF after admission for WHF. | 
 
 
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| E.2.2 | Secondary objectives of the trial  | 
-To demonstrate that, when compared to placebo in the toal patient population, sotagliflozin reduces the total number (i.e., including recurrent events) of the following clinical events:
 -Cardiovascular death, HHF or urgent HF visit.
 -To demostrate that, when compared to placebo, sotagliflozin reduces:
 -The composite of positively adjudicated sustained ≥50% decrease in eGFR, chronic dialysis, renal transplant or positively adjudicated sustained eGFR <15 mL/min/1.73 m2 in the total patient population.
 -Cardiovascular death in patients with LVEF < 50%.
 -Cardiovascular death in the total patient population.
 -All-cause mortality in patients with LVEF < 50%.
 -All cause mortality in the total patient population.
 -To demonstrate the safety and tolerability of sotagliflozin in the total population in this study. | 
 
 
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| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
- Type 2 Diabetes Mellitus.
 -Admitted to the hospital, or urgent heart failure visit for worsening heart failure.
 -Prior diagnosis of heart failure (> 3 months).
 -Prior chronic treatment for heart failure with a loop diuretic (eg furosemide, torsemide, bumetanide) for > 30 days.
 -Randomized when hemodynamically stable, prior to hospital discharge or within 3 days of discharge.
 -Brain natriuretic peptide (BNP) ≥150 pg/mL (≥450 pg/mL for patients with atrial fibrillation) or Nterminal B-type natriuretic peptide ≥600 pg/mL (≥1800 pg/mL for patients with atrial fibrillation).
 -Patients with Left Ventricular Ejection Fraction <40% should be on beta-blockers and RAAS (reninangiotensin-aldosterone system) inhibitors as per local guidelines unless contraindicated.
 -Signed written informed consent. | 
 
 
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| E.4 | Principal exclusion criteria | 
- Age < 18 years or > 85 years.
 -Worsening heart failure attributed to other causes such as pulmonary embolism, stroke, heart attack.
 -Cardiac surgery or coronary procedure within 1 month or planned during study.
 -Lower extremity complications (such as skin ulcer, infection, osteomyelitis, and gangrene) identified during screening and requiring treatment at randomization.
 -Planning to start a sodium-glucose linked transporter-2 (SGLT2) inhibitor during the study.
 -Acute coronary syndromes within 3 months prior to Randomization.
 -Hemodynamically significant uncorrected primary valvular disease.
 -Significant pulmonary disease contributing substantially to the patient’s dyspnea.
 -End stage Heart Failure.
 -History of diabetic ketoacidosis (DKA) or nonketotic hyperosmolar coma within 3 months prior to screening.
 -History of stroke within 3 months prior to randomization.
 -History of dialysis within 1 year prior to randomization.
 -History of solid organ transplant or on a transplant list (if heart transplant, defined as status 1 transplant).
 -Severe kidney disease as defined by eGFR (glomerular filtration rate) <30 mL/min/1.73 m².
 -Pregnancy. | 
 
 
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
- Time to first occurrence of either cardiovascular (CV) death or hospitalization for heart failure (HHF) in patients with left ventricular ejection fraction (LVEF) <50%
 - Time to first occurrence of either CV death or HHF in the total patient population | 
 
 
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| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
| Baseline to approximately 32 months | 
 
 
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| E.5.2 | Secondary end point(s) | 
1. Total number (i.e., including recurrent events) of the following clinical events in the total patient population: Cardiovascular death, Hospitalization for heart failure, Urgent HF visit . 
 2. Time to first occurrence of the composite of positively adjudicated sustained ≥50% decrease in eGFR from Baseline (for ≥30 days), chronic
 dialysis, renal transplant, or positively adjudicated sustained eGFR <15 mL/min/1.73 m2 (for ≥30 days) in the total patient population.
 3. Time to CV death in patients with LVEF <50%
 4. Time to CV death in the total patient population
 5. Time to all-cause mortality in patients with LVEF <50% 
 6. Time to all-cause mortality in the total patient population | 
 
 
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| E.5.2.1 | Timepoint(s) of evaluation of this end point | 
| Baseline to approximately 32 months | 
 
 
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| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  Yes  | 
| E.6.4 | Safety |  Yes  | 
| E.6.5 | Efficacy |  Yes  | 
| E.6.6 | Pharmacokinetic |  No  | 
| E.6.7 | Pharmacodynamic |  No  | 
| E.6.8 | Bioequivalence |  No  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  Yes  | 
| E.6.11 | Pharmacogenomic |  No  | 
| E.6.12 | Pharmacoeconomic |  Yes  | 
| E.6.13 | Others |  No  | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  No  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  Yes  | 
| E.7.4 | Therapeutic use (Phase IV) |  No  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  Yes  | 
| E.8.1.1 | Randomised |  Yes  | 
| E.8.1.2 | Open |  No  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  Yes  | 
| E.8.1.5 | Parallel group |  Yes  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  No  | 
| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  No  | 
| E.8.2.2 | Placebo  |  Yes  | 
| E.8.2.3 | Other |  No  | 
| E.8.2.4 | Number of treatment arms in the trial | 2 | 
| E.8.3 | 
                                The trial involves single site in the Member State concerned
                             |  No  | 
| E.8.4 |  The trial involves multiple sites in the Member State concerned  |  Yes  | 
| E.8.4.1 | Number of sites anticipated in Member State concerned | 19 | 
| E.8.5 | The trial involves multiple Member States |  Yes  | 
| E.8.5.1 | Number of sites anticipated in the EEA | 200 | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA |  Yes  | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  No  | 
| E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned | 
| Argentina | 
 
| Australia | 
 
| Austria | 
 
| Belgium | 
 
| Brazil | 
 
| Canada | 
 
| Chile | 
 
| Czech Republic | 
 
| Denmark | 
 
| Finland | 
 
| France | 
 
| Germany | 
 
| Greece | 
 
| Hungary | 
 
| Israel | 
 
| Italy | 
 
| Korea, Republic of | 
 
| Latvia | 
 
| Lithuania | 
 
| Netherlands | 
 
| New Zealand | 
 
| Poland | 
 
| Portugal | 
 
| Romania | 
 
| Russian Federation | 
 
| Slovakia | 
 
| South Africa | 
 
| Spain | 
 
| Sweden | 
 
| Switzerland | 
 
| Turkey | 
 
| United Kingdom | 
 
| United States | 
 
 
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| E.8.7 | Trial has a data monitoring committee |  Yes  | 
| E.8.8 | 
                        Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial
                     | 
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| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 2 | 
| E.8.9.1 | In the Member State concerned months | 8 | 
| E.8.9.1 | In the Member State concerned days |  | 
| E.8.9.2 | In all countries concerned by the trial years | 2 | 
| E.8.9.2 | In all countries concerned by the trial months | 8 |