NCT03115697

Brief Summary

Study Design- Randomized Controlled trial Duration of enrolment-Feb-2016 to December 2017 Sample size-120 patients Methodology We will include consecutive with advanced hepatic encephalopathy not responding to treatment of precipitants and on treatment with Lactulose and Rifaximin for 48 hours . Two groups will be divided. One arm -Lactulose and Rifaximin will be continued Second Arm - Plasmapheresis will be added to the standard medical care therapy.(Maximum of 3 sessions once in 24 hours/or alternate days with an follow up for 5 days)

Trial Health

30
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Timeline
Completed

Started Apr 2018

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withdrawn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

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

April 12, 2017

Completed
2 days until next milestone

First Posted

Study publicly available on registry

April 14, 2017

Completed
12 months until next milestone

Study Start

First participant enrolled

April 7, 2018

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 15, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 15, 2019

Completed
Last Updated

November 4, 2019

Status Verified

November 1, 2019

Enrollment Period

1 year

First QC Date

April 12, 2017

Last Update Submit

November 1, 2019

Conditions

Outcome Measures

Primary Outcomes (1)

  • Resolution in Hepatic Encephalopathy by 2 grades in both groups

    Day 5

Secondary Outcomes (5)

  • Improvement in Hepatic Encephalopathy in both groups

    2 years

  • Number of days of mechanical ventilation in both groups

    2 years

  • Survival in both groups

    28 days

  • Proportion of patients with Systemic inflammatory response syndrome (SIRS) or sepsis as precipitants of Hepatic encephalopathy in both groups.

    2 years

  • Proportion of patients with failure of standard medical therapy in both groups.

    48 hours

Study Arms (2)

Lactulose with Rifaximin

ACTIVE COMPARATOR
Drug: LactuloseDrug: Rifaximin

Plasmapheresis

EXPERIMENTAL

Plasmapheresis will be added to the standard medical care therapy.(Maximum of 3 sessions once in 24 hours/or alternate days with an follow up for 5 days)

Biological: Plasmapheresis

Interventions

Lactulose 20 mL

Lactulose with Rifaximin

Rifaximin 550 BD

Lactulose with Rifaximin
PlasmapheresisBIOLOGICAL

Plasmapheresis 8 hrly duration

Plasmapheresis

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Cirrhotics
  • Age between 18-70 years
  • Hepatic encephalopathy -Grade 3-4
  • Patients receiving Lactulose/Rifaximin for 48 hours and not showing improvement in Hepatic encephalopathy(Persistent Grade 3/4)

You may not qualify if:

  • Concomitant participation in an other clinical trial
  • Patient receiving sedatives(propofol,etc) 24 hours prior.
  • Patients with severe cardiopulmonary disease
  • Pregnancy
  • Human Immunodeficiency Virus
  • Hepatocellular Carcinoma or extrahepatic malignancy
  • Active uncontrolled sepsis with hemodynamic instability
  • Chronic renal insufficiency on treatment with haemodialysis
  • Uncontrolled bleed or patients in DIC
  • Extremely moribund patients with expected survival of less than 48 hours on high vasopressor support
  • Patients with moderate-severe Acute Respiratory Distress Syndrome (ARDS).
  • Patients with Non Hepatic Coma.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Institute of Liver and Biliary Sciences

New Delhi, National Capital Territory of Delhi, 110070, India

Location

MeSH Terms

Conditions

Hepatic Encephalopathy

Interventions

LactuloseRifaximinPlasmapheresis

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

DisaccharidesOligosaccharidesPolysaccharidesCarbohydratesSugarsRifamycinsHeterocyclic Compounds, 4 or More RingsHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsLactams, MacrocyclicMacrocyclic CompoundsPolycyclic CompoundsBlood Component RemovalTherapeuticsSorption DetoxificationExtracorporeal CirculationSurgical Procedures, Operative
0

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 12, 2017

First Posted

April 14, 2017

Study Start

April 7, 2018

Primary Completion

April 15, 2019

Study Completion

April 15, 2019

Last Updated

November 4, 2019

Record last verified: 2019-11

Locations