- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02048319
Efficacy of Combining Pasireotide With Aspiration Sclerotherapy to Improve Volume Reduction of Hepatic Cysts (Sclerocyst)
Assessing Efficacy of Combining Pasireotide With Aspiration Sclerotherapy to Improve Volume Reduction of Dominant Hepatic Cysts: a Randomized, Double-blind, Placebo-controlled Clinical Trial.
Liver cysts are fluid filled cavities located in the liver. They are present in 2-11% of the general population, typically not causing any symptoms or complications. However, in a small subset of patients complaints of pain, abdominal fullness and distension, dyspnea and nausea occur.
Currently, aspiration and sclerotherapy is a treatment of choice in symptomatic patients with a large dominant liver cyst. However, studies reported early fluid reaccumulation and relative high recurrence rates of cyst growth after aspiration sclerotherapy ultimately leading to re-interventions. In this respect, somatostatin analogues are promising agents known for its volume reducing effect in patients with polycystic liver disease.
In this study the investigators want to evaluate the effect of combining aspiration sclerotherapy with the multi-receptor binding, long-acting somatostatin analogue Pasireotide.
The investigators hypothesize that administrating pasireotide before and after aspiration sclerotherapy could prevent early fluid reaccumulation and thereby result in a greater reduction of cyst diameter. Moreover, the investigators expect a lower rate of cyst recurrence and subsequently lower need for re-interventions.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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-
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Nijmegen, Netherlands, 6500 HB
- Radboud University Nijmegen Medical Center; Department of Gastroenterology & Hepatology
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- All patients who are diagnosed with a dominant liver cyst with an indication for aspiration and sclerotherapy are suitable for inclusion in this study.
In order to be eligible to participate in this study, a subject must meet all of the following criteria:
- Age 18 - 70 years
- Indication for aspiration and sclerotherapy
- Providing informed consent
Exclusion Criteria:
A potential subject who meets any of the following criteria will be excluded from participation in this study
ASPIRATION SCLEROTHERAPY RELATED EXCLUSION CRITERIA:
- Signs of cyst bleeding on ultrasound
- Signs of cyst infection (elevated CRP and/or leukocytes or temperature exceeding 38 degrees with the exclusion of a different focus)
- Cyst < 5 cm
- Coagulopathy (INR > 2 or platelets < 80 x 10^9)
Severe co-morbidity contraindicating anesthesia (i.e. ASA 4 classification)
SOMATOSTATIN TREATMENT RELATED EXCLUSION CRITERIA:
- Patients with a known hypersensitivity to SST analogues or any component of the pasireotide LAR or SQ formulations
- Pregnant or nursing women
- Symptomatic cholecystolithiasis
QT interval related exclusion criteria:
- 9.1 Known (congenital) long QT syndrome or QTcF at screening 470 msec
- 9.2 Family history of long QT syndrome or idiopathic sudden death
- 9.3 Uncontrolled or significant cardiac disease including recent myocardial infarction, congestive heart failure, unstable angina or sustained and/or clinically significant cardiac arrhythmias (e.g. bradycardia)
- 9.4 Risk factors for torsades de pointes: hypokalemia, hypomagnesemia, hypocalcaemia, cardiac failure, clinically significant/symptomatic bradycardia, or high grade AV block
- 9.5 Patients with concomitant disease(s) that could prolong QT such as autonomic neuropathy (caused by diabetes, or Parkinson's disease), HIV, cirrhosis, uncontrolled hypothyroidism or cardiac failure
- 9.6 Taking anti-arrhythmic medicinal products or other substances that are known to lead to QT prolongation
- Uncontrolled diabetes as defined by HbA1C > 64 mmol/ml despite adequate therapy
- History of pancreatitis
Non-malignant medical illnesses that are uncontrolled or whose control may be jeopardized by the treatment with this study treatment
FURTHERMORE:
- Use of oral contraception or estrogen supplementation
- Intervention (i.e. aspiration with or without sclerotherapy or surgical intervention) within six months before baseline
- Treatment with somatostatin analogues within six months before baseline
- Any current or prior medical condition that may interfere with the conduct of the study or the evaluation of its results in the opinion of the investigator
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Experimental: Pasireotide LAR 60 mg
The subjects will be randomized (1:1) into two groups.
Both groups will undergo aspiration sclerotherapy following the standard procedure.
The intervention group will additionally receive two injections of 60 mg pasireotide long-acting release (LAR) intramuscularly: the first injection 14 days before and the second injection 14 days after the intervention.
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Pasireotide long acting release, intramuscular injection
Other Names:
Percutaneous drainage of the hepatic cyst with subsequent ethanol instillation
Other Names:
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Placebo Comparator: Placebo
Patients in the placebo arm will receive two injections of saline solution corresponding to the scheme of the intervention group.
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Percutaneous drainage of the hepatic cyst with subsequent ethanol instillation
Other Names:
Saline solution, injected as placebo
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportional diameter change
Time Frame: 4 weeks
|
Proportional change (%) in cyst diameter measured by ultrasound 4 weeks after aspiration sclerotherapy.
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4 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Absolute reduction (cm) hepatic cyst
Time Frame: 4 weeks
|
Absolute change in cyst diameter measured by ultrasound 4 weeks after aspiration sclerotherapy.
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4 weeks
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Proportional (%) and absolute cyst reduction (cm) after 12 weeks
Time Frame: 12 weeks
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Proportional (%) and absolute change in cyst diameter measured by ultrasound 12 weeks after aspiration sclerotherapy.
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12 weeks
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Proportion cyst recurrence
Time Frame: 12 weeks
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> 80% of its original diameter
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12 weeks
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Symptomatic change and health-related quality of life
Time Frame: 4, 12 weeks and 24 weeks
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Assessment of gastro-intestinal symptoms and health-related quality of life by the GIS- and SF-36 questionnaire respectively
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4, 12 weeks and 24 weeks
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Safety
Time Frame: At week 2, week 4, week 6, week 14 and week 26 after first Pasireotide injection
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Any complications or adverse events reported during procedure or follow-up
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At week 2, week 4, week 6, week 14 and week 26 after first Pasireotide injection
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Proportional (%) and absolute cyst reduction (cm) after 24 weeks
Time Frame: 24 weeks
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Long term proportional (%) and absolute change in cyst diameter measured by ultrasound 24 weeks after aspiration sclerotherapy.
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24 weeks
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Collaborators and Investigators
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- JDTW45115
- 2013-003168-29 (EudraCT Number)
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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