Carvedilol, Endoscopic Variceal Ligation or Combination of Both for Prevention of First Variceal Bleed in Child's B & C Cirrhosis

Carvedilol, Endoscopic Variceal Ligation or Combination of Both for Prevention of First Variceal Bleed in Child's B & C Cirrhosis: A Randomized Controlled Trial

Study Design: Open labeled randomized controlled trial. The study will be conducted on patients attending outpatient or admitted to admitted to Department of Hepatology from January 2017 to December 2018 at ILBS, New Delhi

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

330

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Delhi
      • New Delhi, Delhi, India, 110070
        • Institute of Liver and Biliary Sciences

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Liver Cirrhotics between 18-70 yrs of age (cirrhosis diagnosed on the basis of clinical, biochemical, fibroscan & imaging.)
  • CTP ≥ 7-15 (Child's B/C)
  • Small esophageal varices with RCS and large esophageal varices (>5 mm)
  • No history of previous bleed

Exclusion Criteria:

  • Malignancy-HCC, PVT
  • Child A
  • MELD >35
  • Contraindications to β blockers.
  • Platelet count < 30,000/mm3
  • Previous endoscopic variceal treatment. (Beyond 21 days)
  • Patients having an indication for TIPS or requiring more than 1 therapeutic ascitic tapping/month
  • Post TIPS, Shunt surgery
  • Acute kidney injury (Sr.Cr>1.5mg/dl)
  • Non cirrhotic portal hypertension
  • Acute on chronic liver failure

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Carvedilol
Carvedilol will start at starting dose of 3.125 mg BD followed by 6.25 mg BD followed by 12.5 mg BD if BP 90/60 mmHg and HR 55/min
Experimental: Carvedilol+EVL
Carvedilol will start at starting dose of 3.125 mg BD followed by 6.25 mg BD followed by 12.5 mg BD if BP 90/60 mmHg and HR 55/min
EVL will be done every 3 weeks till eradication
Active Comparator: EVL
EVL will be done every 3 weeks till eradication

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Reduction in the incidence of first variceal bleed at 1 year.
Time Frame: 1 year
1 year

Secondary Outcome Measures

Outcome Measure
Time Frame
Overall and bleed related Survival in all the 3 groups
Time Frame: 1 year
1 year
Bleed related Survival in all the 3 groups
Time Frame: 1 year
1 year
Improvement in Child-Turcotte-Pugh (CTP) score in all the 3 groups
Time Frame: 1 year
1 year
Improvement in Model for End Stage Liver Disease (MELD) score in all the 3 groups
Time Frame: 1 year
1 year
Incidence of Spontaneous Bacterial Peritonitis (SBP) in all the 3 groups
Time Frame: 1 year
1 year
Incidence of Acute Kidney Injury (AKI) in all the 3 groups
Time Frame: 1 year
1 year
Incidence of Shock in all the 3 groups
Time Frame: 1 year
1 year
Incidence of new ascites in all the 3 groups
Time Frame: 1 year
1 year
HVPG response at 1year in all the 3 groups
Time Frame: 1 year
1 year
Treatment related side effects in all the 3 groups
Time Frame: 1 year
1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 15, 2017

Primary Completion (Anticipated)

November 30, 2020

Study Completion (Anticipated)

November 30, 2020

Study Registration Dates

First Submitted

February 28, 2017

First Submitted That Met QC Criteria

March 1, 2017

First Posted (Actual)

March 3, 2017

Study Record Updates

Last Update Posted (Actual)

February 19, 2020

Last Update Submitted That Met QC Criteria

February 18, 2020

Last Verified

October 1, 2019

More Information

Terms related to this study

Other Study ID Numbers

  • ILBS-Cirrhosis-07

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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