- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03703674
GCSF in Alcoholic Hepatitis
Granulocyte Colony Stimulating Factor in Alcoholic Hepatitis
Alcoholic hepatitis is related to very high mortality rate. About 40% of the patients are died within first 6 months after the detection of the clinical syndrome. Therefore, it is very essential for proper diagnosis and early treatment. In response to acute or chronic liver damage, bone marrow derived stem cells can spontaneously populate liver and differentiate into hepatic cells. Animal and human studies suggested that injured hepatocyte may be replaced by pluripotent bone marrow cells. However, this hepatocyte repopulation is highly dependent on varieties of liver injury and therapeutic conditions. The studies has suggested Granulocyte-colony stimulating factors (G-CSF) can regenerate hepatocyte by fusing with hematopoietic cells, thereby enhancing the liver histology and survival rate.
G-CSF is a cytokine capable to regulate a number of functions in neutrophils. In three recent studies mobilization of bone marrow stem cells induced by G-CSF was observed in patients with alcoholic hepatitis. In two of this studies there was a survival benefit with the use of G-CSF.
Therefore we plan to study the safety and efficacy of G-CSF in the patients with alcoholic hepatitis.
Study Overview
Detailed Description
Detailed Description:
Patients with severe alcoholic hepatitis, admitted to Department of Hepatology PGIMER, Chandigarh will be included in the study.
METHODS
This will be an open label trial. A randomization code is generated by random number table. The patients will be randomized to receive standard medical therapy (SMT) only as control and therapy of G-CSF as case. There will be one control and one case as below:
1) SMT (control) 2) G-CSF (case): G-CSF 5 mcg/kg every 12 hourly for consecutive 5 days This will be a single time therapy. Patients will be admitted in the department of hepatology and will be assessed everyday clinically as well as by laboratory tests during therapy to assess safety and effects of treatment.
- Total leukocytes count will be assessed daily.
- Circulating CD 34 positive cells will be measured on day 0 and 6 of G-CSF therapy.
- In addition, ultrasonography will be performed at day 1 and 6 in order to evaluate difference in spleen size and portal vein flow.
- Biochemical, coagulation, and hematological parameters (Liver function tests, Renal Function Tests, Prothrombin Time, International Normalised Ratio, etc.) will be monitored periodically, daily for 1 week, then weekly for 1month and monthly for three month.
All patients will be followed at weekly interval for 1 month and then monthly for 3 months.
Outcome:
Primary Objectives:
Survival at 3 months
Secondary Objectives:
Mobilisation of CD34 positive cells in peripheral blood.Clinical/biochemical improvement in liver function profile.Improvement in prognostic scores-Maddrey's Discriminant function, MELD score, and Child score.
Safety and efficacy of G-CSF in alcoholic hepatitis
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Chandigarh, India, 160012
- Recruiting
- Post Graduate Institute of Medical Education and Research
-
Contact:
- Virendra Singh
- Phone Number: 7087009338
- Email: virendrasingh100@hotmail.com
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Alcoholic hepatitis patients:
- More than 10 years of heavy alcohol consumption (mean intake ≈ 100 g/day).
- Elevated aspartate aminotransferase level (but <500 IU per millilitre) and Ratio ofAST/ALT≥2 times
- Elevated serum total bilirubin level ≥ 5 mgdL (86 μmol/L)
- Elevated INR(≥1.5) and
- Neutrophilia. Patient with Maddrey's DF of ≥ 32 will be included in the study, with or without biopsy.
Exclusion Criteria:
- 1. Age < 18 and > 75 years 2. Hepatocellular carcinoma or portal vein thrombosis 3. Refusal to participate in the study 4. Serum creatinine>1.0 mg% 5. Hepatic encephalopathy- grade 3 or 4 6. Upper gastrointestinal bleed in last ten days 7. Uncontrolled bacterial infection 8. Human immunodeficiency virus, Hepatitis B virus, Hepatitis C virus seropositivity, Autoimmune hepatitis, hemochromatosis, Wilson's disease, alpha1-antitrypsin deficiency 9. Pregnancy 10. Glucocorticoid treatment 11. Significant co-morbidity 12. Previous known hypersensitivity to G-CSF
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Standard Medical Therapy
Drug: standard medical therapy Standard medical therapy involves primary treatment and normal hospital nutrition (1800 to 2000 kcal per day).
Diuretics, sodium restriction and albumin for treatment of ascites or fresh frozen plasma for coagulopathy or antibiotics for any focus of infection as spontaneous bacterial peritonitis (SBP), pneumonia, cellulitis, and urinary tract infection as indicated.
|
Granulocyte-colony stimulating factors (G-CSF)
|
EXPERIMENTAL: G-CSF + Standard Medical Therapy
Drug: standard medical therapy Standard medical therapy involves primary treatment and normal hospital nutrition (1800 to 2000 kcal per day). Diuretics, sodium restriction and albumin for treatment of ascites or fresh frozen plasma for coagulopathy or antibiotics for any focus of infection as spontaneous bacterial peritonitis (SBP), pneumonia, cellulitis, and urinary tract infection as indicated. Drug: G-CSF G-CSF- 5 μg/Kg s.c every 12 hours for 5 consecutive days |
Granulocyte-colony stimulating factors (G-CSF)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Survival at 3 months
Time Frame: 90 DAYS
|
90 DAYS
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Mobilisation of CD34 positive cells in peripheral blood.
Time Frame: 6 DAYS
|
6 DAYS
|
Improvement in MELD score
Time Frame: 90 DAYS
|
90 DAYS
|
Improvement in Maddrey's Discriminant Function.
Time Frame: 90 Days
|
90 Days
|
Improvement in Child Turcotte Pugh score.
Time Frame: 90 Days
|
90 Days
|
Number of participants with treatment-related adverse events in the different groups.
Time Frame: 90 Days
|
90 Days
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
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
- Chemically-Induced Disorders
- Digestive System Diseases
- Alcohol-Related Disorders
- Substance-Related Disorders
- RNA Virus Infections
- Virus Diseases
- Infections
- Liver Diseases
- Hepatitis, Viral, Human
- Enterovirus Infections
- Picornaviridae Infections
- Liver Diseases, Alcoholic
- Alcohol-Induced Disorders
- Hepatitis
- Hepatitis A
- Hepatitis, Alcoholic
Other Study ID Numbers
- GCSF IN ALCOHOLIC HEPATITIS
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.
Clinical Trials on Alcoholic Hepatitis
-
Seoul St. Mary's HospitalGlaxoSmithKlineTerminatedNASH (Non-alcoholic Steato-hepatitis)
-
University Hospital, LilleRecruitingAlcoholic Liver Disease | Severe Alcoholic Hepatitis | Alcoholic CirrhosisFrance
-
HepQuant, LLCWithdrawnSevere Alcoholic HepatitisUnited States
-
Vital Therapies, Inc.CompletedAcute Alcoholic HepatitisUnited States, Spain, Australia, United Kingdom
-
Vital Therapies, Inc.TerminatedAcute Alcoholic HepatitisUnited States, Spain, United Kingdom, Germany, Austria, Ireland
-
Institute of Liver and Biliary Sciences, IndiaNot yet recruiting
-
Institute of Liver and Biliary Sciences, IndiaUnknownSevere Alcoholic HepatitisIndia
-
Vital Therapies, Inc.TerminatedSevere Acute Alcoholic HepatitisUnited States, Spain, United Kingdom, Germany
-
CHU de ReimsCompletedSevere Alcoholic HepatitisFrance
-
MedRegen LLCNot yet recruitingAlcoholic Hepatitis | Acute Alcoholic Hepatitis
Clinical Trials on GCSF
-
Tianjin SinoBiotech Ltd.CompletedChemotherapy-induced NeutropeniaChina
-
Tianjin SinoBiotech Ltd.CompletedChemotherapy-induced NeutropeniaChina
-
Tianjin SinoBiotech Ltd.Peking University Cancer Hospital & InstituteCompletedCancer | Tumor | Underdose (Unintentional)China
-
Adello Biologics, LLCCelerionCompletedHealthy VolunteersUnited States
-
Jules Bordet InstituteUnknown
-
BiocadCompletedChemotherapy-induced NeutropeniaRussian Federation
-
SCRI Development Innovations, LLCNovartis PharmaceuticalsTerminatedSmall Cell Lung Cancer | Ovarian CancerUnited States
-
Stanford UniversityRecruitingCervix Cancer | Endometrial CancerUnited States
-
Memorial Sloan Kettering Cancer CenterCompletedBeta Thalassemia Major | Congenital AnemiasUnited States
-
Shantha Biotechnics LimitedCompletedChemotherapy-Induced NeutropeniaIndia