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Biodegradable Stents in Primary Sclerosing Cholangitis (BSTPSC)

27. maj 2026 opdateret af: King's College Hospital NHS Trust

Pilot Study of Biodegradable STents in Primary Sclerosing Cholangitis - BSTPSC

In patients with PSC, endoscopic therapy of strictures aims to improve cholestasis by relieving the biliary obstruction via endoscopic biliary dilatation with consideration of plastic stents in strictures refractory to dilatation due to the risk of pancreatitis and cholangitis . Short term stents have been shown to have similar recurrence-free rates compared to dilatation in a randomised control trial; however, this was terminated after interim analysis due to higher rates of serious adverse events in the stent group. The long term benefits are unclear; however, it may lead to improved survival compared to predicted survival. In this group of patients with limited treatment options, biodegradable stents may provide an attractive additional treatment modality in the management of high grade strictures.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Research hypothesis

The use of biodegradable stents leads to remodelling of high grade strictures in patients with PSC with fewer interventions in comparison to balloon dilation alone with a comparable risk profile to current therapy.

Primary endpoint

Technical success and safety of biodegradable stent placement at ERC

Secondary endpoints

  • Cumulative recurrence -free rate of primary high grade strictures within 12 months
  • Change in symptoms as assessed by the Amsterdam cholestatic complaints score (ACCS)
  • Clinical success is defined by improvement in liver function tests (LFT) by 20% at week 2 and week 12.
  • Improvement in quality fo life as assessed by the Short form-36 (SF-36).
  • Mortality, morbidity, local complications, stricture recurrence, decompensation of liver disease, liver transplantation over 12 months.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

20

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • PSC patients with a high grade stricture

Exclusion Criteria:

  • Prior stenting or balloon dilatation within the previous 4 months
  • Signs of bacterial cholangitis as defined by definite cholangitis
  • Change of UDCA therapy within 4 weeks
  • Inability to give informed consent
  • Biliary cirrhosis with Child Pugh score > 8
  • Estimated transplant free survival < 2 years as calculated by Mayo score > 2
  • Suspicion of cholangiocarcinoma, reflected by an imaging study suggestive of metastasis, MRCP with mass lesion with contrast enhancenment, or rise in CA19.9 of > 63 U/ml in the previous 4 months together with an absolute value > 130 U/ml
  • Signs of current malignancy other than basal cell carcinoma
  • Life expectancy < 24 months
  • Women pregnant at the time of screening
  • HIV or acute or chronic hepatitis B or hepatitis C or substance (drug or alcohol) misure within the previous 2 years.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Archimedes stent insertion
Archimedes stent insertion at ERCP for patients with PSC and a HGS
Enhed: archimedes stent
archimedes stent for HGS

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Deployment of biodegradable stent placement across stricture at ERC in 20 patients
Tidsramme: at time of primary ERC
Deployment of stent across the stricture - yes or no
at time of primary ERC

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Cumulative recurrence -free rate of primary high grade strictures within 12 months.
Tidsramme: through study completion up to 12 months
has the stricture reoccured (yes or no) at 12 months post ERC and stent
through study completion up to 12 months
Change in symptoms as assessed by the Amsterdam cholestatic complaints score (ACCS)
Tidsramme: Post ERC to assessment at 2 weeks and 12 weeks, and at 12 months.
change in pruritus, fatigue, pain and fever
Post ERC to assessment at 2 weeks and 12 weeks, and at 12 months.
Mortality over 12 months.
Tidsramme: Within 12 months of primary ERCP
Death related to PSC
Within 12 months of primary ERCP
morbidity related to ERC
Tidsramme: within 12 months of ERC
Complications including cholangitis and pancreatitis post ERC
within 12 months of ERC
stricture recurrence post ERC
Tidsramme: 12 months post ERC
Development of a stricture in the bile duct
12 months post ERC
Development of ascites post erc
Tidsramme: up to 12 months post ERC
development of abdominal ascites post ERC
up to 12 months post ERC
Need for liver transplantation
Tidsramme: up to 12 months following ERC
patients who are assessed and then listed for liver transplant
up to 12 months following ERC
Clinical success is defined by improvement in liver function tests (LFT) by 20% at week 2 and week 12.
Tidsramme: At week 2 and 12 weeks post ERCP

Change in liver blood tests:

- ALP, AST, ALT, Bilirubin
At week 2 and 12 weeks post ERCP
Change in quality fo life as assessed by the Short form-36 (SF-36
Tidsramme: after ERC and assesment at 2 weeks, 12 weeks and 12 months
Change in QoL
after ERC and assesment at 2 weeks, 12 weeks and 12 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

King's College Hospital NHS Trust

Efterforskere

  • Ledende efterforsker: DEEPAK JOSHI, PhD, King's College Hospital NHS Trust

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. marts 2026

Primær færdiggørelse (Anslået)

1. april 2027

Studieafslutning (Anslået)

1. april 2027

Datoer for studieregistrering

Først indsendt

20. april 2026

Først indsendt, der opfyldte QC-kriterier

20. maj 2026

Først opslået (Faktiske)

26. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

29. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

27. maj 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • IRAS 336318

Plan for individuelle deltagerdata (IPD)

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UBESLUTET

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Kliniske forsøg med Primær skleroserende kolangitis (PSC)

Kliniske forsøg med archimedes stent

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