Trial of Psychoeducational and Hypnosis Interventions on the Fatigue Associated With PBC in Women

NCT03630718 | Completed

• 1 other identifier: K180401J
• Study Type: interventional
• Target: 55
• Locations: 1 country
• Sites: 1

Brief Summary

Fatigue is a clinical symptom that has been described as the most disturbing by around 50% of patients with PBC. It has an important impact on patients' quality of life and is associated with an increased mortality risk. To treat fatigue in PBC, only medical treatments have been tested with limited efficacy or serious sides' effects. In other diseases, mostly cancer, psychological interventions showed efficacy on fatigue decrease. Most interventions consist in psychoeducation with: education about fatigue, development of self-care or coping techniques, activity management and learning to balance between activities and rest. Hypnosis, which consists in a body work for psycho-therapeutic use (e.g., through imagination), has also shown promising results. Moreover, psychological intervention efficacy seems to be influenced by patients' characteristics, such as personality. Therefore, the first aim of the present single-center randomized controlled phase 2 trial is to assess the efficacy of a psycho educational intervention and a hypnosis intervention on PBC patients' fatigue to demonstrate that both psychoeducational and hypnosis interventions decrease patient fatigue.

Conditions

Liver Cirrhosis, Biliary

Keywords

Liver Cirrhosis, Biliary; Female; Cholangitis; Hypnosis; Psychological treatment

Outcome Measures

Primary Outcomes (1)

• PBC-40 questionaire

  At month 3

Secondary Outcomes (23)

• Short Form Health Survey (SF36) (1)

  At Day 0

• Short Form Health Survey (SF36) (2)

  At week 5

• Short Form Health Survey (SF36) (3)

  At month 3

• Short Form Health Survey (SF36) (4)

  At month 6

• Multidimensional fatigue inventory (MFI) (1)

  At Day 0

Study Arms (3)

Control Group (CG)

NO INTERVENTION

Patients assigned to no intervention

Psychoeducational Intervention Group (EG-EDU)

ACTIVE COMPARATOR

Patients assigned to psychoeducational intervention

Behavioral: Psychoeducational Intervention

Hypnosis intervention Group (EG-HYP)

ACTIVE COMPARATOR

Patients assigned to hypnosis intervention

Behavioral: Hypnosis intervention

Interventions

Psychoeducational Intervention BEHAVIORAL

The psychoeducational intervention will be a structured education programme and will consist of informing patients about fatigue dimensions, aetiology and treatments, by helping them to develop strategies to cope with fatigue better and by teaching them to manage the balance between activities and rest. The construction of the contents of the sessions of this intervention will aim to reduce fatigue via the programme developed by Reif et al. in cancer patients and is composed of 6 sessions of 90 minutes, one session per week. It is a group intervention for 8 patients. For this project, the investigators have reorganised the sessions and their content to fit with an individual format adapted to PBC. This format is more appropriate to take into account the specificity of the manifestation of fatigue for each patient.

Also known as: EG-EDU

Psychoeducational Intervention Group (EG-EDU)

Hypnosis intervention BEHAVIORAL

The hypnosis intervention will consist of decreasing fatigue and the related distress, and increasing feelings of energy and well-being. Therefore, each hypnosis exercise will be audiotaped and given to the patient at the end of the session. Patients will be asked to use these recordings as much as they want to help them to manage fatigue. The techniques used are inspired by those used in chronic pain management and fatigue.

Also known as: EG-HYP

Hypnosis intervention Group (EG-HYP)

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Women from 18 to 75 years old,
• Diagnosis of primary biliary cholangitis (PBC) according to recognized criteria (EASL 2017),
• Medically stable under treatment with UDCA initiated for at least 6 months, ie medically stable on the basis of liver biological parameters (no increase of more than 20% in bilirubin, ALP and transaminases) and absence of disabling pruritus (permanent and EVA\> 6/10 or scratching lesions),
• Presenting a significant level of fatigue (fatigue score on PBC-40\>= 33),
• Understanding the French language,
• Availability and ability of the patient to access an internet network terminal to answer the online questionnaires of the study,
• Signed consent form.

You may not qualify if:

• Presence of cirrhosis with a Child-Pugh B or C,
• Presence of disabling pruritus (permanent, or EVA\>= 7/10 in the last 3 weeks, or objectivable scratching skin lesions),
• Patient on liver transplantation waiting list or total bilirubin\> 50 μmol / L (3 mg / dL), or recent complication (\<6 months) of cirrhosis (ascites, hepatic encephalopathy, rupture bleeding) of esophageal varices),
• Untreated depressive disorder,
• Any comorbidity not medically controlled (i.e. all dosage changes \<3 months due to a control of the associated pathology deemed insufficient by the referring physician) or life-threatening in the medium term (within 2 years).
• Psychiatric disorder modifying the relationship to the reality

Sponsors & Collaborators

• Assistance Publique - Hôpitaux de Paris: lead
• University of Paris 5 - Rene Descartes: collaborator

Study Sites (1)

Service hépatologie Hôpital Saint-Antoine

Paris, 75012, France

Location

Related Publications (1)

• Untas A, Goffette C, Flahault C, Vioulac C, Chazouilleres O, Soret PA, Ben Belkacem K, Gaouar F, Bernard N, Rousseau A, Corpechot C. PBC-HOPE: A Randomized Controlled Trial of Hypnosis and Psychoeducation in Women With Primary Biliary Cholangitis and Fatigue. Am J Gastroenterol. 2025 Jul 14. doi: 10.14309/ajg.0000000000003639. Online ahead of print.

  PMID: 40658125 DERIVED

MeSH Terms

Conditions

Liver Cirrhosis, Biliary; Cholangitis

Condition Hierarchy (Ancestors)

Cholestasis, Intrahepatic; Cholestasis; Bile Duct Diseases; Biliary Tract Diseases; Digestive System Diseases; Liver Diseases; Liver Cirrhosis; Fibrosis; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Christophe CORPECHOT, MD

  Assistance Publique - Hôpitaux de Paris

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 15, 2018
• First Posted: August 15, 2018
• Study Start: May 27, 2019
• Primary Completion: May 17, 2023
• Study Completion: May 22, 2023
• Last Updated: June 25, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)