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Hepatic CirrhosisNCT02778425

The Treatment of Hepatocirrhosis and Portal Hypertension

A study testing Endoscopic therapy+ beta blockers, Endoscopic therapy+ PSE+beta blockers and beta blockers in people with Hepatic Cirrhosis and Portal Hypertension, run by Yanjing Gao at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study compare the efficiency of partial splenic embolization +endoscopical therapy with endoscopical therapy alone in gastroesophageal variceal haemorrhage accompanied with splenomegaly or hypersplenism of hepatocirrhosis and portal hypertension treatment. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Hepatic Cirrhosis, Portal Hypertension
What is being tested?
Endoscopic therapy+ beta blockers, Endoscopic therapy+ PSE+beta blockers and beta blockers
Could I receive a placebo?
No, everyone receives an active treatment
How many people
108 participants
Where
1 siteChina
Study dates
Feb 2016to Jan 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients aged between 18 and 75 years
  • Patients who had recovered from an episode of VH or patients who had survived from acute VH and there was no bleeding for consecutive 5 days
  • Patients with a diagnosis of liver cirrhosis and portal hypertension on clinical examination, laboratory test, and imaging or histological examination
  • Patients with hypersplenism and thrombocytopenia (platelets < 100,000/µL).

Who cannot join

  • Previous therapy (splenectomy, PSE, EVL, tissue adhesive injection, or usage of (NSBB) to prevent rebleeding
  • Bleeding from isolated gastric or ectopic varices
  • Hepatocellular carcinoma or other malignant tumors
  • Contraindications for the use of NSBBs, hepatic failure, and Child-Pugh class C with large amount ascites, or grade 3-5 hepatic encephalopathy, or prothrombin activity ≤ 40%
  • Hepatic failure
  • Contraindications for PSE
  • Pregnancy and lactation
  • Inability to sign the informed consent.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Department of Gastroenterology,Qilu Hospital,Shandong University

    Jinan, Shandong, 250012

Other trials in China

About this study

Official title: Partial Splenic Embolization Combined with Endoscopic Therapies and NSBB Decreases the Variceal Rebleeding Rate and Increases Recompensation Rate in Cirrhosis Patients with Hypersplenism: a Multicenter Randomized Controlled Trial

This study compare the efficiency of partial splenic embolization +endoscopical therapy with endoscopical therapy alone in gastroesophageal variceal haemorrhage accompanied with splenomegaly or hypersplenism of hepatocirrhosis and portal hypertension treatment.

Read the detailed description

Endoscopic therapy is the mature treatment of gastroesophageal variceal haemorrhage and PSE is an effective method for treatment of the hypersplenism and portal hypertension. Existing researches show that endoscopic therapy + PSE is more effective than endoscopic therapy alone in prevention of esophageal varices bleeding recurrence in the patients with liver cirrhosis. However, there is few articles which proved long-term effectiveness of endoscopic therapy + PSE, it needs further research on this issue. This study compares the efficiency of partial splenic embolization +endoscopic therapy with endoscopic therapy alone in the treatment of gastroesophageal variceal haemorrhage accompanied with splenomegaly or hypersplenism in the patients with hepatocirrhosis and portal hypertension.

Being tested
Endoscopic therapy+ beta blockers, Endoscopic therapy+ PSE+beta blockers, beta blockers, Endoscopic therapy, Endoscopic therapy+ PSE
Keywords
Partial splenic embolization, Hypersplenism, Thrombocytopenia, Portal hypertension, Gastroesophageal varices, Secondary prophylaxis, Endoscopic variceal ligation, Non-selective beta-blocker, hepatic recompensation
Medical subject headings
Liver Cirrhosis, Hypertension, Portal, Hypersplenism, Thrombocytopenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Endoscopic therapy+ beta blockersProcedure or surgery

    Endoscopic variceal ligation (EVL) is for the secondary prophylaxis of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).A standard dose of NSBB (propranolol) was applied to patients according to the Baveno VI recommendations if there were no contraindications.

  • Endoscopic therapy+ PSE+beta blockersProcedure or surgery

    Endoscopic variceal ligation (EVL) is for the secondary prophylaxis of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).A standard dose of NSBB (propranolol) was applied to patients according to the Baveno VI recommendations if there were no contraindications.Partial splenic embolization (PSE) is one of the intra-arterial therapeutic approaches to embolize 60-80% splenic blood flow.

  • beta blockersProcedure or surgery

    A standard dose of NSBB (propranolol) was applied to the primary prevention patients according to the Baveno VI recommendations if there were no contraindications.

  • Endoscopic therapyProcedure or surgery

    Endoscopic variceal ligation (EVL) is for the primary prophylaxis of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).

  • Endoscopic therapy+ PSEProcedure or surgery

    Endoscopic variceal ligation (EVL) is for the primary prophylaxis of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).Partial splenic embolization (PSE) is one of the intra-arterial therapeutic approaches to embolize 60-80% splenic blood flow.

  • Somatostatin+Endoscopic therapyProcedure or surgery

    The first dose of 250 was injected intravenously, followed by a continuous iv infusion of 250 for 3-5 days. Endoscopic variceal ligation (EVL) is for the acute bleeding of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).

  • Somatostatin+Endoscopic therapy+PSEProcedure or surgery

    The first dose of 250 was injected intravenously, followed by a continuous iv infusion of 250 for 3-5 days. Endoscopic variceal ligation (EVL) is for the acute bleeding of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).Partial splenic embolization (PSE) is one of the intra-arterial therapeutic approaches to embolize 60-80% splenic blood flow.

Study groups in NCT02778425
Study groupRoleWhat they receive
Secondary prevention-1ExperimentalEndoscopic therapy+ beta blockers
Receives: Procedure: Endoscopic therapy+ beta blockers
Secondary prevention-2ExperimentalEndoscopic therapy+ PSE+beta blockers
Receives: Procedure: Endoscopic therapy+ PSE+beta blockers
Primary prevention-1ExperimentalBeta blockers
Receives: Procedure: beta blockers
Primary prevention-2ExperimentalEndoscopic therapy
Receives: Procedure: Endoscopic therapy
Primary prevention-3ExperimentalEndoscopic therapy+ PSE
Receives: Procedure: Endoscopic therapy+ PSE
Acute bleeding-1ExperimentalSomatostatin+endoscopic therapy
Receives: Procedure: Somatostatin+Endoscopic therapy
Acute bleeding-2ExperimentalSomatostatin+endoscopic therapy+PSE
Receives: Procedure: Somatostatin+Endoscopic therapy+PSE

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The primary endpoint was variceal rebleeding

    The rebleeding rate of the varices in the EP group will compared to that in the E group during the follow up.

    Measured: 2 years

  2. The primary outcome was the hepatic recompensation rate based on Baveno VII criteria after 1-year follow-up.

    The hepatic recompensation rate based on Baveno VII criteria in the EP group will compared to that in the E group during the follow-up. Hepatic recompensation is a comprehensive assessment index defined as meeting all of the following criteria simultaneously: (1)Etiological Control: Removal/suppression/cure of the primary cause of cirrhosis (e.g., hepatitis C virus elimination, sustained suppression of hepatitis B virus, and sustained abstinence from alcohol in alcoholic cirrhosis); (2)Symptomatic Resolution: Regression of ascites (discontinuation of diuretics), remission of hepatic encephalopathy (discontinuation of lactulose/rifaximin), and absence of recurrent variceal bleeding (for at least 12 months); (3)Improvement in Liver Function: Stable improvement in liver function tests (albumin, INR, bilirubin).

    Assessed via lab tests (HCV RNA, HBV DNA, albumin, INR, bilirubin) and clinical evaluation (ascites, encephalopathy, endoscopy). Reported as binary (Yes/No).

    Measured: 2 years

Secondary outcomes (3)
  1. The secondary endpoints were severe variceal recurrence and mortality during the 2-year follow-up

    The recurrence rate of the varices in the EP group will compared to that in the E group during the follow up.

    Measured: 2 years

  2. Changes of the peripheral blood cell counts including white blood cell, red blood cell, and platelate counts in both group during 2-years follow up.

    The physiological parameters including white blood cell (*10^9/L), red blood cell (*10^12/L) and platelte(*10^12/L) will compared between the two groups.

    Measured: 2 years

  3. The secondary endpoints were changes in Child-Pugh Score, MELD Score, and Physiological Parameters during the follow-up.

    Changes in liver function (Child-Pugh score, MELD score) and physiological parameters (white blood cell count [*10^9/L], red blood cell count [*10^12/L], platelet count [*10^12/L], hemoglobin [g/dL], and coagulation parameters) will be assessed and compared during the 1-year follow-up between the two groups.

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 May 2016 (estimated)
  2. Study startFeb 2016
  3. Primary completionDec 2019
  4. Study completionJan 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
108 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02778425
Sponsor's protocol ID
201602-QILU
Status last verified
Sep 2021
First submitted
8 May 2016
Last updated
14 Feb 2025
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Yes: All the individual participant data (IPD) available to other researchers.

Publications

  • Wei M, Chen Y, Wang M, Li J, Zeng Y, Sun X, Zhang A, Liu X, Zhou T, Gao Y. Partial splenic embolization combined with endoscopic therapies and vasoconstrictive drugs reduces rebleeding in cirrhosis patients with acute variceal bleeding and hypersplenism: a multicenter randomized controlled trial. J Gastroenterol. 2023 Nov;58(11):1144-1153. doi: 10.1007/s00535-023-02027-1. Epub 2023 Jul 24.

    PubMed 37486372
  • Sun X, Zhang A, Zhou T, Wang M, Chen Y, Zhou T, Chen X, Xiu A, Peng Z, Cheng B, Liu X, Gao Y. Partial splenic embolization combined with endoscopic therapies and NSBB decreases the variceal rebleeding rate in cirrhosis patients with hypersplenism: a multicenter randomized controlled trial. Hepatol Int. 2021 Jun;15(3):741-752. doi: 10.1007/s12072-021-10155-0. Epub 2021 Feb 27.

    PubMed 33638769

Questions about this trial

What is this clinical trial studying?

A study testing Endoscopic therapy+ beta blockers, Endoscopic therapy+ PSE+beta blockers and beta blockers in people with Hepatic Cirrhosis and Portal Hypertension, run by Yanjing Gao at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The primary endpoint was variceal rebleeding (time frame: 2 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02778425, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Feb 2025.

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