- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03279809
The Effect of Aspirin on Patency of Metal Stent in Malignant Distal Bile Duct Obstruction
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background -Endoscopic drainage is the first choice for bile drainage in patients with malignant distal biliary obstruction. Metal stents are mainly used for malignant biliary obstruction if the surgical treatment is not considered. Metal stents have proven superior in many clinical aspects over plastic stents. Nonetheless, the maintenance period of the metallic stent patency has been reported to be around 8 months, and it is often necessary to undergo further procedure due to dysfunction of stents. Recently, it has been reported that the duration of the metallic stent patency in patients with aspirin is prolonged. Since the previous study was a retrospective study, this study will be prospectively conducted as a randomized controlled study with aspirin treated patients who received metal stents in patients over 20 years who were confirmed malignant distal biliary obstruction. The incidence of stent dysfunction in both groups for 6 months after the procedure will be compared. Stent dysfunction is defined as any case which further procedure is required due to jaundice or cholangitis after stent insertion.
Study aim
-The aim of this study is to determine whether administration of aspirin can help maintain the patency of metallic stents for distal malignant common bile duct obstruction.
Data analysis
- Blinding will remain in place until the statistician codes the statistical analyses of the primary and secondary outcomes. The statistical analyses will be done using the full analysis set according to the intention-to-treat principle, meaning all the randomized patients will be analyzed in their allocated groups regardless of any protocol violations or early treatment discontinuations. The outcomes through a per-protocol analysis set that will consider only the subjects who followed the protocol effectively will be analyzed.
- The rate of stent dysfunction will be compared using Pearson's chi-squared test with Fisher's exact test and calculated the odds ratio of the event. The secondary outcomes (i.e., the duration of stent patency, the rate of reintervention, and the adverse events related to aspirin administration) will be analyzed using Pearson's chi-squared test with Fisher's exact test, Student's t-test, and Kaplan-Meier curves stratified by drug and the hazard ratios between two groups using the Cox proportional hazards. The further affecting factors for stent dysfunction will be assessed by univariable and multivariable logistic regression analysis.
- In the initial plan, it was decided not to perform interim analysis, but it was confirmed that more adverse events occurred than expected in the process of conducting the study. Therefore, the interim analysis was performed with the data up to May 2020, and determine whether to continue the study by measuring the benefits and losses obtained from aspirin.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Jongno-gu
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Seoul, Jongno-gu, Korea, Republic of, 110-744
- Seoul National University Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Malignant distal bile duct obstruction
- Over 20 years old
- Techinical success of endoscopic retrograde biliary drainage with metalic stent
Exclusion Criteria:
- Patient's denial
- Previous Aspirin use
- Aspirin allergy
- Contraindication for aspirin
- Life expectancy < 6mo
- Gastroduodenal ulcer
- History of substance abuse
- Participation in a clinical trial within the past 30 days
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: Intervention
Intervention : aspirin medication Case with aspirin medication for 6 months after stenting
|
Aspirin medication (100mg daily) after biliary stent insertion for malignant obstruction
Other Names:
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Placebo Comparator: Control
Control : placebo medication Case with placebo medication for 6 months after stenting
|
Case with placebo medication for 6 months after stenting
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of stent dysfunction
Time Frame: 6 months after biliary metalic stent
|
Dysfunction after 6 months from stenting
|
6 months after biliary metalic stent
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Duration of metalic stent patency
Time Frame: 6 months after biliary metalic stent
|
Duration from insertion time to metallic stent dysfunction time
|
6 months after biliary metalic stent
|
Incidence of further procedures
Time Frame: 6 months after biliary metalic stent
|
Incidence of further procedures needed for biliary drainage
|
6 months after biliary metalic stent
|
Adverse events related with aspirin
Time Frame: 6 months after biliary metalic stent
|
Adverse events which clearly related with aspirin admistration including bleeding event
|
6 months after biliary metalic stent
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Woo Hyun Paik, MD, PhD, Seoul National University Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Biliary Tract Diseases
- Bile Duct Diseases
- Cholestasis
- Cholestasis, Extrahepatic
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Analgesics
- Sensory System Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Fibrinolytic Agents
- Fibrin Modulating Agents
- Platelet Aggregation Inhibitors
- Cyclooxygenase Inhibitors
- Antipyretics
- Aspirin
Other Study ID Numbers
- H-1707-161-874
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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