Assessing Portal Hypertension With Methacetin Breath Test
Clinical Study of the BreathID® LF System to Train the Algorithm for the ¹³C-Methacetin Breath Test (MBT) in Assessment of Portal Hypertension in Patients With Compensated Liver Cirrhosis
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Paris, France
- Hôpital Beaujon
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Toulouse, France
- Hopital Purpan
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Barcelona, Spain
- (University of Barcelona) Hospital Clinic
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Madrid, Spain
- Hospital Universitario Ramon Y Cajal
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Bern, Switzerland, 3010
- Inselspital
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Connecticut
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New Haven, Connecticut, United States, 06516
- VA Connecticut Healthcare System
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North Carolina
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Durham, North Carolina, United States, 27710
- Duke University Medical Center
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Virginia
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Richmond, Virginia, United States, 23298
- Virginia Commonwealth University
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adult men or women (>18 years of age)
- Known chronic liver disease with cirrhosis
- Europe: Indicated to undergo HVPG testing
- US: Consented for HVPG
- For patients treated with beta blockers: They have to be on a stable dose for at least 6 weeks prior to any study related tasks
- For patients who stopped their treatment with beta blockers: Their last dose should be at least 6 weeks prior to any study related tasks
Exclusion Criteria:
- Decompensated cirrhosis as clinically defined by the presence of ascites, hepatic encephalopathy, variceal bleeding or hepatorenal syndrome
- Renal failure (creatinine > 2.5 mg/dl)
- Known acute renal tubular disease Known hypotension (Systolic Pressure <100mmHg)
- Hypocoagulablity defined as PT >6 and INR >2.3.
- Congestive heart failure (assessed clinically as NIHA >2)
- Known pulmonary hypertension (right ventricular systolic pressure > 45 mm Hg)
- Uncontrolled diabetes mellitus (HBA1C >9.5gr%)
- Concurrent prednisone or immunosuppressive treatment, if therapy and/or response to treatment are not stable for at least 3 months.
- Documented or suspected hepatocellular carcinoma
- Gastric bypass surgery or extensive small bowel resection
- Total parenteral nutrition
- Any organ transplant recipient
- Pregnant or breast feeding
- Allergy to acetaminophen and/or other related medications
- Documented drug-related concurrent hepatotoxicity or drug-related silent steatosis or drug-related fibrosis (e.g. amiodarone, methotrexate and tamoxifen)
- Uncontrolled malabsorption or diarrhea
- Documented non-cirrhotic PHT, partial / complete portal venous occlusion, hepatic venous occlusion, previous PHT surgery, or placement of a transjugular intrahepatic portosystemic shunt (TIPS)
- Primary or secondary biliary cirrhosis, primary or secondary sclerosing cholangitis, hepatic sarcoidosis, or other cholestatic disorders
- Subjects unable to perform the MBT within 7 days of HVPG procedure.
- Subject should not have taken any of the following for at least 48 hours prior to the breath test: Acyclovir , allopurinol, amiodarone, carbamazepine, cimetidine, ciprofloxacin, daidzein, (herbal) disulfiram, echinacea, enoxacin, famotidine, fluvoxamine, methoxsalen, mexiletine, montelukast, norfloxacin, phenylpropanolamine, phenytoin, propafenone, rifampin, terbinafine, ticlopidine, thiabendazole, verapamil, zileuton or oral contraceptives or any medication that might interfere with Methacetin metabolism or might affect CYP 1A2
- Subject should not have taken amiodarone or statins within the last 30 days prior to the breath test or HVPG procedure
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Compensated cirrhotic patients
A methacetin breath test will be performed on patients who are undergoing the HVPG procedure due to their clinical indication of compensated cirrhosis.
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13C labelled methacetin solution for breath test monitoring
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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CSPH (Clinically Significant Portal Hypertension)
Time Frame: 1 hour
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Clinically significant portal hypertension is defined as Hepatic Venous Pressure Gradient (HVPG)>=10mmHg, whereby the portal pressure leaving the liver is measured by using a balloon catheter before and after a wedge.
The difference of the pressure between the wedge and the free is the hepatic venous pressure gradient.
Methacetin breath test is hypothesized to also identify CSPH and the agreement to the reference standard (HVPG) will be assessed in this study.
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1 hour
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Hepatic Venous Pressure Gradient (HVPG)>=12; Severe Portal Hypertension (SPH)
Time Frame: 1 hour
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Hepatic Venous Pressure Gradient greater than 12 (SPH) is an indicator of bleeding varices.
whereby the portal pressure leaving the liver is measured by using a balloon catheter before and after a wedge.
The difference of the pressure between the wedge and the free is the hepatic venous pressure gradient.
Methacetin breath test is hypothesized to also identify SPH and the agreement to the reference standard (HVPG) will be assessed in this study.
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1 hour
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Juan Carlos Garcia Pagan, MD, University Hospital Barcelona
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CSPH-EX-4014
- 2014-002037-59 (EudraCT Number)
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