Efficacy and Safety of E.Coli Nissle 1917 in Patients With Mild (Stage 1-2) or Minimal Hepatic Encephalopathy
Probiotic E.Coli Nissle 1917 Comparing to Lactulose and Rifaximin in Patients With Mild (Stage 1-2) or Minimal Hepatic Encephalopathy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Cirrhosis diagnosed on the basis of liver biopsy, liver stiffness measurement or radiological study;
- presence of minimal or mild (Grade 1-2) HE as defined by West Haven criteria;
- two or more documented episodes of HE in the last 6 months, in addition to at least one episode in the last 3 months;
- subject is capable and willing to comply with all study procedures;
- signed inform consent.
Exclusion Criteria:
- history of taking L-ornithine- L -aspartate, zinc, metronidazole, or neomycin, antibiotics, probiotics and yogurt consumption within 6 weeks;
- subject has a history of allergy or intolerance to lactulose and/or rifaximin;
- alcohol intake during the past 6 month or during follow up;
- recent (6 weeks) gastro-intestinal bleed;
- hepato-cellular carcinoma or liver transplantation;
- renal insufficiency;
- significant comorbid illness such as heart or respiratory failure;
- concurrent infection such as spontaneous bacterial peritonitis, pneumonia or urinary tract infection;
- any neurologic diseases such as alzheimer's disease, parkinson's disease and nonhepatic metabolic encephalopathies;
- subject has any condition or circumstance that would, in the opinion of the Investigator, prevent completion of the study or interfere with analysis of study results, including history of noncompliance with treatments.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: E.coli Nissle 1917
probiotic, oral, for the first 4 days, 1 capsule, and then 2 capsules per day for 1 month treatment
|
Probiotic contains biomass of E.coli Nissle 1917, 2,5-25·109 colony forming units - CFU/g
Other Names:
|
|
ACTIVE_COMPARATOR: Lactulose
will receive 30-60 ml of lactulose in 2 or 3 divided doses so that patient passed 2-3 semisoft stools per day, 1 months of treatment
|
will receive 30-60 ml of lactulose in 2 or 3 divided doses so that patient passed 2-3 semisoft stools per day, 1 months of treatment
Other Names:
|
|
ACTIVE_COMPARATOR: Rifaximin
rifaximin, oral, 500 mg BID, 1 months of treatment
|
rifaximin, oral, 500 mg BID, 1 months of treatment
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Change in Stroop test
Time Frame: 1 month
|
1 month
|
|
Change in serum ammonia
Time Frame: 1 month
|
1 month
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in serum inflammatory cytokine
Time Frame: 1 month
|
The level of IL-6, IL-8 and INFγ in pg / ml will be assesed
|
1 month
|
|
Bacteriology measured in the stool flora by specialized non-culture techniques
Time Frame: 1 month
|
The percentage of patients in each group were evaluated and characterized by a decrease below the normal content of symbiotic bacteria Bifidobacterium (less than 107 CFU / g), lactobacilli (less than 107 CFU / d), E.coli with normal properties (less than 106 CFU / d) and increase in content E.coli with altered properties (more than 106 CFU / g), pathogenic enterobacteria (not normally detected) and fungi of the genus Candida (more than 104 CFU / d)
|
1 month
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Elina Manzhalii, PhD, Bogomolets National Medical University
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 (ACTUAL)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
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
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Liver Failure
- Hepatic Insufficiency
- Pathologic Processes
- Metabolic Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Brain Diseases, Metabolic
- Liver Diseases
- End Stage Liver Disease
- Fibrosis
- Liver Cirrhosis
- Hepatic Encephalopathy
- Brain Diseases
- Anti-Infective Agents
- Gastrointestinal Agents
- Anti-Bacterial Agents
- Rifaximin
- Lactulose
Other Study ID Numbers
Other Study ID Numbers
- HepEN
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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