NCT03056274

Brief Summary

This is a pilot study aimed at comparing the effect of metformin versus ursodeoxycholic acid in women with intrahepatic cholestasis in pregnancy. The study will be conducted in three NHS hospital sites, over an 18 month period.

Trial Health

35
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
40

participants targeted

Target at P25-P50 for phase_2

Timeline
Completed

Started Jan 2019

Shorter than P25 for phase_2

Status
unknown

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

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 22, 2016

Completed
2 months until next milestone

First Posted

Study publicly available on registry

February 17, 2017

Completed
1.9 years until next milestone

Study Start

First participant enrolled

January 1, 2019

Completed
5 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2019

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2019

Completed
Last Updated

July 26, 2018

Status Verified

January 1, 2018

Enrollment Period

5 months

First QC Date

December 22, 2016

Last Update Submit

July 24, 2018

Conditions

Keywords

MetforminUrsodeoxycholic acidOutcomes

Outcome Measures

Primary Outcomes (2)

  • Normalisation of maternal serum concentration of bile salts and liver enzymes

    Normalisation of Bile acids and liver enzymes - both parameters are the cornerstone for a diagnosis of intrahepatic cholestasis. They have been separated into two outcomes due to to the different laboratory indices of measurement. Results will be aggregated together to report number of patients with abnormal results

    From date of randomisation to date of delivery assessed up to 26 weeks

  • Normalisation of maternal serum concentration of liver enzymes

    Normalisation of liver enzymes Alanine transaminase Aspartate transaminase Bilirubin (total) Gamma glutamyl transferase Results will be aggregated together to report the number of patients with abnormal liver enzymes

    From date of randomisation to date of delivery assessed up to 26 weeks

Secondary Outcomes (6)

  • Fetal outcomes

    From date of randomisation to date of delivery assessed up to 26 weeks

  • Fetal outcomes

    From date of randomisation to date of delivery assessed up to 26 weeks

  • Fetal outcomes

    Immediately upon delivery date

  • Fetal outcomes

    Immediately upon delivery date

  • Fetal outcomes

    Immediately upon delivery date

  • +1 more secondary outcomes

Other Outcomes (9)

  • Fetal outcomes

    Immediately upon delivery date

  • Fetal outcomes

    Immediately upon delivery date

  • Fetal outcomes

    Immediately upon delivery date

  • +6 more other outcomes

Study Arms (2)

Metformin arm

ACTIVE COMPARATOR

Metformin

Drug: Ursodeoxycholic Acid

Ursodeoxycholic acid

ACTIVE COMPARATOR

Ursodeoxycholic acid

Drug: Metformin

Interventions

Metformin Hydrochloride (HCl) Tablets, is an oral antihyperglycemic drug used in the management of type 2 diabetes

Also known as: Glucophage
Ursodeoxycholic acid

Ursodeoxycholic acid (UDCA) is used to treat gallstones and primary biliary cirrhosis. UDCA is also used to treat obstetric cholestasis (OC), a liver condition that occurs specifically in pregnancy.

Also known as: Destolit®, Urdox®, Ursofalk®, Ursogal®
Metformin arm

Eligibility Criteria

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

You may qualify if:

  • +0 to 40 weeks' gestation on day of randomisation
  • Itching with a raised serum bile acid above the upper limit of normal
  • Normal anomaly scan at 20 weeks
  • Aged 18 years or over
  • Able to give written informed consent
  • No known pre-existing liver disease

You may not qualify if:

  • Decision already made for delivery within the next 48 hours
  • Known allergy to any component of the ursodeoxycholic acid or metformin tablets
  • Patients already on metformin for other conditions

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (2)

  • Elfituri A, Ali A, Shehata H. Managing Recurring Obstetric Cholestasis With Metformin. Obstet Gynecol. 2016 Dec;128(6):1320-1323. doi: 10.1097/AOG.0000000000001748.

  • Walker KF, Chappell LC, Hague WM, Middleton P, Thornton JG. Pharmacological interventions for treating intrahepatic cholestasis of pregnancy. Cochrane Database Syst Rev. 2020 Jul 27;7(7):CD000493. doi: 10.1002/14651858.CD000493.pub3.

MeSH Terms

Conditions

Cholestasis, IntrahepaticPregnancy Complications

Interventions

MetforminUrsodeoxycholic Acid

Condition Hierarchy (Ancestors)

CholestasisBile Duct DiseasesBiliary Tract DiseasesDigestive System DiseasesLiver DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital Diseases

Intervention Hierarchy (Ancestors)

BiguanidesGuanidinesAmidinesOrganic ChemicalsDeoxycholic AcidCholic AcidsBile Acids and SaltsSteroidsFused-Ring CompoundsPolycyclic CompoundsCholanes

Study Officials

  • Hassan Shehata, FRCPI, FRCOG

    Epsom & St Helier University Trust

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Hassan Shehata, FRCPI, FRCOG

CONTACT

Amanda Ali, MRCPI, MRCOG

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

December 22, 2016

First Posted

February 17, 2017

Study Start

January 1, 2019

Primary Completion

June 1, 2019

Study Completion

September 1, 2019

Last Updated

July 26, 2018

Record last verified: 2018-01

Data Sharing

IPD Sharing
Will not share