NCT02086825

Brief Summary

The aim of the current study is to determine whether rifaximin or lactulose is more effective in preventing the development of severe hepatic encephalopathy in hospitalized patients with cirrhosis and new onset kidney failure. Subjects will be randomly assigned to one of two treatment groups: Group A: Lactulose 20g dose titrated to 2-3 soft-formed bowel movements per day Group B: Rifaximin 550mg tablet twice daily. Subjects will be followed daily for two weeks or until hospital discharge. Treatment success is defined as prevention of grade 3 or 4 HE during hospitalization.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Geographic Reach
1 country

1 active site

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 11, 2014

Completed
1 month until next milestone

First Posted

Study publicly available on registry

March 13, 2014

Completed
1.6 years until next milestone

Study Start

First participant enrolled

October 1, 2015

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2016

Completed
Last Updated

March 2, 2016

Status Verified

March 1, 2016

Enrollment Period

1.2 years

First QC Date

February 11, 2014

Last Update Submit

March 1, 2016

Conditions

Outcome Measures

Primary Outcomes (1)

  • Development of Progressive Hepatic Encephalopathy to Stage 3 or 4 in patients with progressive renal failure

    The primary outcome for this study is the development of progressive hepatic encephalopathy to stage 3 or 4 in patients with progressive renal failure. For the purpose of this study, acute renal failure is defined as a progressive and sustained increase in serum creatinine \>0.5mg/dl from baseline to a value of 2.0mg/dl, irrespective of etiology in 3 days. Renal failure is progressive and sustained if there is no improvement after volume resuscitation with 1.5 L of normal saline or equivalent colloid infusion (serum albumin or blood product transfusion).

    90 days (including follow-ups)

Secondary Outcomes (2)

  • In-hospital mortality

    Patient's hospital stay up to 14 days

  • Hospital Length of Stay

    Up to 14 days

Study Arms (2)

Rifaximin

EXPERIMENTAL
Drug: Rifaximin

Lactulose

EXPERIMENTAL
Drug: Lactulose

Interventions

(Xifaxin®, Salix Pharmaceuticals) 550mg tablet twice daily.

Also known as: Xifaxin
Rifaximin

20g dose titrated

Lactulose

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18 years or older
  • Cirrhosis of the liver based on biopsy or clinical and radiographic criteria
  • Ability to provide informed consent (Grade 0 to 1 HE)
  • Acute renal failure (increase in baseline creatinine of 0.5mg/dL to a value of \>2.0 mg/dL within 3 days).
  • Absence of improvement in renal function after adequate fluid resuscitation using either normal saline or blood products (25% salt poor albumin, fresh frozen plasma, or packed red blood cells)

You may not qualify if:

  • Previous history of sensitivity/allergy to lactulose or rifaximin or rifampin
  • Pregnancy
  • Inability to obtain informed consent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

New York University Langone Medical Center

New York, New York, 10010, United States

Location

MeSH Terms

Conditions

Hepatic Encephalopathy

Interventions

RifaximinLactulose

Condition Hierarchy (Ancestors)

Liver FailureHepatic InsufficiencyLiver DiseasesDigestive System DiseasesBrain Diseases, MetabolicBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesMetabolic DiseasesNutritional and Metabolic Diseases

Intervention Hierarchy (Ancestors)

RifamycinsHeterocyclic Compounds, 4 or More RingsHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsLactams, MacrocyclicMacrocyclic CompoundsPolycyclic CompoundsDisaccharidesOligosaccharidesPolysaccharidesCarbohydratesSugars

Study Officials

  • Samuel Sigal

    NYU MEDICAL CENTER

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 11, 2014

First Posted

March 13, 2014

Study Start

October 1, 2015

Primary Completion

December 1, 2016

Last Updated

March 2, 2016

Record last verified: 2016-03

Locations