- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06026267
Efficacy of Conventional Dose Protocol vs Low Dose Protocol Albumin Use in Patients With Cirrhosis and High Risk Spontaneous Bacterial Peritonitis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Hypothesis Alternate Hypothesis: Low dose albumin is as effective as conventional dose albumin in cirrhosis with high risk SBP patients having AKI development or progression by day 4.
Aim:-To compare the efficacy and safety of low dose albumin with conventional dose albumin in AKI development or progression in patients with cirrhosis and high risk spontaneous bacterial peritonitis.
Study population: Patients of age > 18 years of age with cirrhosis of liver who are admitted in ward/ICU diagnosed with high risk SBP.
Study design: Randomized controlled trial Study period:1.5year Sample size: 300 (150 cases in each group) Assuming that the rate of AKI development in conventional dose albumin group - 10% and low dose albumin group 15%, Power- 80%, Alpha- 10% ONE SIDED, Non inferiority limit- 5, cases needed to enroll are 270, further assuming 10% dropout, investigator decided to enroll total 300 cases, randomly allocated with 150 cases in each arm by block randomization method with Block size of 10 Cases will be randomly allocated in 2 groups by block randomization method with block size taken as 10.
STATISTICAL ANALYSIS:
Continuous variables- Mean +/- SD Categorical variables as percentages (%) or Frequencies Student t test will be applied in continuous data compared with two groups Survival analysis like Cox-Regression model and Kaplan-Meir plots will be plotted to find the possible factors responsible for mortality Besides these, Intent to treat (ITT) and Per Protocol (PP) will be done at the time of data analysis.
Adverse effects:
Patients receiving Albumin may experience Nausea, Vomiting, Fever with chills, dyspnea Wheezing, Volume overload, Anaphylactic reaction
Stopping rule of study:
Adverse reaction to drug Cardiopulmonary compromise
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Dr Sourav Paul, MD
- Phone Number: 01146300000
- Email: saurav.paul79@gmail.com
Study Locations
-
-
Delhi
-
New Delhi, Delhi, India, 110070
- Institute of Liver & Biliary Sciences
-
Contact:
- Dr Saurabh Paul, MD
- Phone Number: 01146300000
- Email: saurav.paul79@gmail.com
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age >18years
- Cirrhosis with SBP (community acquired /Health care associated/ nosocomial)
- High risk SBP : Patients with S Bil >4 mg/dL and/or s creat > 1 mg/dl at presentation
Exclusion Criteria:
- Antibiotic treatment within one week before the diagnosis of SBP (except for prophylactic treatment with norfloxacin)
- Significant cardiac failure, pulmonary disease
- Known CKD or findings suggestive of organic nephropathy (proteinuria, haematuria, or abnormal findings on renal USG)
- Hepatocellular carcinoma
- HIV infection
- GI bleed within 1 month before the study
- Grade 3 to 4 hepatic encephalopathy
- Shock (MAP < 65)
- Serum creatinine level of > 3 mg/decilitre
- Presence of any potential causes of dehydration (such as diarrhea or an intense response to diuretic treatment within one week before the diagnosis of SBP).
Study Plan
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 |
---|---|
Experimental: High Dose Arm
Human Albumin 20% 1.5 g/kg body weight (Maximum 100g) on day 1 after the diagnosis, followed by 1 g/kg body weight (Maximum 100g)on day 3 along with standard medical therapy.
|
Standard Medical Treatment
A]. Patients in the conventional albumin Arm will receive Human Albumin 20% 1.5 g/kg body weight (Maximum 100g) on day 1 after the diagnosis, followed by 1 g/kg bodyweight (Maximum 100g)on day 3 along with standard medical therapy
|
Active Comparator: Reduced Dose Albumin+Standard Medical therapy
Human Albumin 20% 1.0 g/kg body weight (Maximum 100g) on day 1 after the diagnosis, followed by 0.5 g/kg bodyweight (Maximum 100g) on day 3 along with standard medical therapy.
|
Standard Medical Treatment
B]. Patients in the low dose albumin Arm will receive Human Albumin 20% 1.0 g/kg body weight (Maximum 100g) on day 1 after the diagnosis, followed by 0.5 g/kg bodyweight (Maximum 100g) on day 3 along with standard medical therapy
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Proportion of patients developing new AKI or having progression of AKI by day 4.
Time Frame: Day 4
|
Day 4
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Resolution of Spontaneous Bacterial Peritonitis by day 5
Time Frame: Day 5
|
Resolution is defined as decrease in ascitic fluid PMN > 25% from baseline
|
Day 5
|
Change on Serum Ascites Albumin Gradient (SAAG) in both the groups.
Time Frame: Day 5
|
Day 5
|
|
Change in cell count (PMN) in both groups.
Time Frame: Day 5
|
Day 5
|
|
Changes in PRA levels from baseline to day 7
Time Frame: day 7
|
day 7
|
|
Changes in TNF-alpha levels from baseline to day 7
Time Frame: day 7
|
day 7
|
|
Changes in IL-6 levels from baseline to day 7
Time Frame: day 7
|
day 7
|
|
Changes in endotoxin levels from baseline to day 7
Time Frame: day 7
|
day 7
|
|
Changes in renal resistive index from baseline to day 7
Time Frame: day 7
|
day 7
|
|
Number of patients with development of complications in both groups
Time Frame: 90 days
|
90 days
|
|
Number of Participants with changes in ProBNP from baseline to day 4 or if shortness of breath occurs
Time Frame: Day 4
|
Day 4
|
|
Number of Participants with changes in vWF-Ag from baseline to day 4
Time Frame: Day 4
|
Day 4
|
|
Number of patients expired in both the groups
Time Frame: Day 7
|
Day 7
|
|
Number of patients expired in both the groups
Time Frame: Day 28
|
Day 28
|
|
Number of patients expired in both the groups
Time Frame: Day 90
|
Day 90
|
|
Duration of hospital stay
Time Frame: 90 days
|
90 days
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Other Study ID Numbers
- ILBS-Cirrhosis-59
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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