- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00742339
Terlipressin + Albumin Versus Midodrine + Octreotide in the Treatment of Hepatorenal Syndrome
October 11, 2014 updated by: University of Padova
Terlipressin + Albumin Versus Midodrine + Octreotide in the Treatment of Hepatorenal Syndrome (HRS): An Open Multicentric Randomized Study
From 1999, several studies have showed that the use of vasoconstrictors in association with albumin are effective in the treatment of hepatorenal syndrome (HRS).
The rationale of the use of vasoconstrictors together with albumin in the treatment of this severe complication of portal hypertension in patients with cirrhosis is to correct the reduction of the effective circulating volume due to the splanchnic arterial vasodilatation.In most of these studies terlipressin, a derivate of vasopressin, has been used as vasoconstrictor as intravenous boluses moving from an initial dose of 0.5-1 mg/4 hr.
In some studies midodrine, an alpha-adrenergic agonist, given by mouth has been used as vasoconstrictor at a dose ranging from 2.5 up to 12.5 tid together with octreotide, an inhibitor of the release of glucagon, given subcutaneously at a dose ranging from 10 µg upt to 200 µg tid.
To the day, there isn't a study comparing terlipressin + albumin versus midodrine + octreotide + albumin in the treatment of HRS in patients with cirrhosis.Thus, the aim of the study is to compare terlipressin + albumin vs midodrine + octreotide + albumin in the treatment of the HRS in patients with cirrhosis.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
49
Phase
- Phase 2
- Phase 3
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
-
-
-
Padova, Italy, 35100
- Dept. of Clinical and Experimental Medicine, University of Padova
-
-
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 75 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients with cirrhosis and diagnosis of HRS type 1 or 2,serum creatinine > 2.5 mg/dl
Exclusion Criteria:
- Diagnosis of HCC with a staging beyond the Milan Criteria di Milano
- Septic shock (systolic arterial pressure < 90 mmHg
- Significant heart or respiratory failure
- Peripheral arteriophaty clinically significant
- Previous heart stroke or significant alteration of the ECG
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 |
---|---|
Active Comparator: 1
Fifty patients with cirrhosis and HRS will be randomly assigned to arm 1.
|
The terlipressin will be give at the initial dose of 3 mg/24 hours by intravenous continuous infusion.
If during the following 48 hours the serum value of creatinine will not change or will go down less than 25%, the dose of terlipressin will be increased to 6 mg/24 hours.
If no response will ensue, the dose of terlipressin will be increased to the maximal dose of 12 mg/24 hours.
Twenty percent human albumin solution will be administrate together with terlipressin at the dosage of 1 g/Kg of body weight, on first day, and then, to the dosage of 20-40 g/Kg in order to maintain the central venous pressure (CVP) between 10 and 15 cm H2O.The treatment with terlipressin and albumin will be maintained for 24 hours after complete or incomplete resolution.
The length of the study in patients with complete and incomplete resolution will reach a maximum of 15 days.
In the patients without response the treatment with the high dosage of terlipressin will go on for a maximum of 7 days.
|
Experimental: 2
Fifty patients with cirrhosis and HRS will be randomly assigned to arm 2.
|
Midodrine will be give orally at the initial dose 7.5 tid together with octreotide at the initial dosage of 100 µg subcutaneously tid.
If during the following 96 hours the serum value of creatinine will not change or will go down less than 25%, the dose of midodrine will be increased to 12.5 mg tid Twenty percent human albumin solution will be administrate together with midodrine and octreotide at the dosage of 1 g/Kg of body weight, on first day, and then, to the dosage of 20-40 g/Kg in order to maintain the central venous pressure (CVP) between 10 and 15 cm H2O.The treatment with terlipressin and albumin will be maintained for 24 hours after complete or incomplete resolution.
The length of the study in patients with complete and incomplete resolution will reach a maximum of 15 days.
In the patients without response the treatment with the high dosage of terlipressin will go on for a maximum of 7 days.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The primary end-point of the study is the complete reform of the renal function (serum creatinine < 1.5 mg/dl. The primary end point will be evaluated at the end of the treatment.
Time Frame: The treatment will be continued for a maximum of 15 days
|
The treatment will be continued for a maximum of 15 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
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
May 1, 2005
Primary Completion (Actual)
October 1, 2013
Study Completion (Actual)
October 1, 2013
Study Registration Dates
First Submitted
August 26, 2008
First Submitted That Met QC Criteria
August 26, 2008
First Posted (Estimate)
August 27, 2008
Study Record Updates
Last Update Posted (Estimate)
October 15, 2014
Last Update Submitted That Met QC Criteria
October 11, 2014
Last Verified
October 1, 2014
More Information
Terms related to this study
Keywords
- cirrhosis
- hepatorenal syndrome
- terlipressin
- midodrine
- octreotide
- human albumin
- effective circulating volume
- The criteria which will be used for the diagnosis of HRS will be the criteria which were recently published by the International Ascites Club
- Patients with cirrhosis and type 2 HRS only with serum creatinine value > 2.5 mg/dl
- All patients with cirrhosis and type 1 HRS
Additional Relevant MeSH Terms
- Digestive System Diseases
- Pathologic Processes
- Kidney Diseases
- Urologic Diseases
- Disease
- Liver Diseases
- Fibrosis
- Syndrome
- Liver Cirrhosis
- Hepatorenal Syndrome
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Antihypertensive Agents
- Autonomic Agents
- Peripheral Nervous System Agents
- Antineoplastic Agents
- Gastrointestinal Agents
- Antineoplastic Agents, Hormonal
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Sympathomimetics
- Vasoconstrictor Agents
- Adrenergic alpha-1 Receptor Agonists
- Octreotide
- Terlipressin
- Midodrine
Other Study ID Numbers
- 1264P
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.
Clinical Trials on Cirrhosis
-
Postgraduate Institute of Medical Education and...Society for the Study of Liver Diseases, Chandigarh ( India )UnknownDecompensated Cirrhosis of LiverIndia
-
University Health Network, TorontoUnknown
-
National Institute of Diabetes and Digestive and...National Institute on Alcohol Abuse and Alcoholism (NIAAA); National Cancer... and other collaboratorsRecruitingCirrhosis | Cirrhosis, Liver | Cirrhosis Due to Hepatitis B | Cirrhosis Due to Hepatitis C | Cirrhosis Early | Cirrhosis Advanced | Cirrhosis Infectious | Cirrhosis Alcoholic | Cirrhosis, Biliary | Cirrhosis Cryptogenic | Cirrhosis Due to Primary Sclerosing CholangitisUnited States
-
Chia Tai Tianqing Pharmaceutical Group Co., Ltd.RecruitingPrimary Biliary CirrhosisChina
-
Northwestern UniversityNational Institute on Alcohol Abuse and Alcoholism (NIAAA); National Cancer... and other collaboratorsRecruitingCirrhosis | Cirrhosis, Liver | Cirrhosis Due to Hepatitis B | Cirrhosis Due to Hepatitis C | Cirrhosis Early | Cirrhosis Advanced | Cirrhosis Infectious | Cirrhosis Alcoholic | Cirrhosis, Biliary | Cirrhosis Cryptogenic | Cirrhosis Due to Primary Sclerosing CholangitisUnited States
-
RenJi HospitalNot yet recruiting
-
Nanfang Hospital, Southern Medical UniversityRecruiting
-
Institute of Liver and Biliary Sciences, IndiaRecruiting
-
SUUMC Central Military Hospital Dr Carol DavilaRecruiting
-
The Cleveland ClinicRecruiting
Clinical Trials on Terlipressin plus albumin
-
University of PadovaUnknownCirrhosis | Type 1 Hepatorenal SyndromeItaly
-
Pere GinesUnknownCirrhosis | Hepatorenal Syndrome Type ISpain
-
Jena University HospitalGerman Research Foundation; Center for Clinical Studies, Jena University Hospital and other collaboratorsRecruitingAcute Kidney Injury | Cirrhosis, Liver | Hepatorenal Syndrome | Ascites HepaticGermany
-
Shanghai Zhongshan HospitalUnknownLiver Failure | Acute Kidney Injury | Ascites Hepatic | Terlipressin Adverse ReactionChina
-
Instituto Mexicano del Seguro SocialCompletedEsophageal and Gastric VaricesMexico
-
Institute of Liver and Biliary Sciences, IndiaCompletedAcute-On-Chronic Liver Failure | Acute Kidney Injury | Hepatorenal SyndromeIndia
-
Amany Mousa Salama MuhammedNot yet recruiting
-
University Hospital FreiburgUniversity Hospital Muenster; Johannes Gutenberg University Mainz; Jena University...Not yet recruitingLiver Cirrhosis | Chronic Kidney Diseases | Hepato-Renal Syndrome
-
Hospital Clinic of BarcelonaCompleted
-
Institute of Liver and Biliary Sciences, IndiaTerminatedAcute on Chronic Liver FailureIndia