Rifaximin vs Placebo for the Prevention of Encephalopathy in Patients Treated by TIPS (PRPET)
2026年4月29日 更新者：University Hospital, Toulouse
Double Blind Randomized Study, Comparing Rifaximin vs Placebo for the Prevention of Encephalopathy in Patients Treated by TIPS
TIPS has been used for 20 years, as a means of reducing portal pressure in patients with cirrhosis and portal hypertension related complications.
TIPS proved more effective than alternative treatments in controlling or preventing variceal bleeding and refractory ascites.
The main drawback of the TIPS procedure is progressive overt hepatic encephalopathy (OHE).
Three risk factors for post-TIPS OHE have been identified: age over 65 years, history of previous episodes of OHE, and Child-Pugh score equal to or over 10.
However, the incidence of post-TIPS OHE in patients fulfilling these criteria remains close to 35 %.
研究概览
详细说明
TIPS has been used for 20 years, as a means of reducing portal pressure in patients with cirrhosis and portal hypertension related complications.
TIPS proved more effective than alternative treatments in controlling or preventing variceal bleeding and refractory ascites.
The main drawback of the TIPS procedure is progressive overt hepatic encephalopathy (OHE).
Three risk factors for post-TIPS OHE have been identified: age over 65 years, history of previous episodes of OHE, and Child-Pugh score equal to or over 10.
However, the incidence of post-TIPS OHE in patients fulfilling these criteria remains close to 35 %.
Furthermore, the pathogenesis of HE in general but also in patients treated by TIPS is still not well understood.
Therefore, there is a real challenge in discovering new molecular mechanisms involved in pathogenesis of OHE as well as new treatment to better prevent the risk of OHE in patients treated by TIPS.
Observational and experimental studies suggest a microbiota's role in the mechanism of OHE and recently a non absorbable antibiotic has proven to reduce the risk of recurrence of OHE.
However, the effect of this drug for the prevention of a first episode of OHE in patients treated by TIPS is not known.
In addition, the mechanisms of the beneficial effect of rifaximin remain poorly understood.
研究类型
介入性
注册 (实际的)
211
阶段
- 第三阶段
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
-
-
Angers、法国
- CHU Angers
-
Bondy、法国
- Hôpital Jean Verdier
-
Bordeaux、法国
- Chu Bordeaux
-
Lille、法国
- CHRU Lille
-
Marseille、法国
- CHU Marseille
-
Nantes、法国
- Chu Nantes
-
Paris、法国
- CHU Saint-Antoine
-
Paris、法国
- CHU Beaujon Clichy
-
Paris、法国
- Pitié Salpêtrière
-
Poitiers、法国
- CHU Poitiers
-
Rennes、法国
- CHU Rennes
-
Tours、法国
- CHU Tours
-
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France
-
Toulouse、France、法国、31059
- UHToulouse
-
-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 80年 (成人、年长者)
接受健康志愿者
不
描述
Inclusion Criteria:
- cirrhosis with TIPS for ascit treatment or hydrothorax
- prevention digestive bleeding follow up portal hypertension -
- signed consent
Exclusion Criteria:
- hepatocellular carcinoma out of Milan criteria or palliative phase cancer
- Child Pugh score > 12
- TIPS indicated for other indication than bellow
- encephalopathy signs : asterixis or confusion
- Hypersensibility to rifaximin, or derivated of rifamycin
- Patients treated by same class antibacterial
- pregnant woman
- Patient with hepatic transplant
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的：rifaximin
6 rifaximin caps of 200 mg per day morning and night, during 15 days before TIPS, and after TIPS during 6 months.
|
6 rifaximin caps of 200 mg morning and night, 15 days before and 6 months after TIPS --------------------------------------------------------------------------------
其他名称：
|
|
安慰剂比较：placebo
6 caps placebo morning and night, 15 days before and 6 months after TIPS
|
6 placebo caps per day morning and night, during 15 days before TIPS and 6 months after TIPS
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
First episode of overt encephalopathy in patients treated by TIPS
大体时间：6 months
|
First episode of overt encephalopathy in patients treated by TIPS
|
6 months
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
number of hospitalisation days
大体时间：6 months
|
Number and days of hospitalisations for encephalopathy
|
6 months
|
|
Frequency of kidney insufficiency
大体时间：6 months
|
number of digestive bleeding follow up to portal hypertension, number of ascit punctions, frequency kidney insufficiency and hepatocellular carcinoma
|
6 months
|
|
transplants, deaths
大体时间：6 months
|
- number of transplants and deaths
|
6 months
|
|
intestinal microbiota
大体时间：6 months
|
Composition of intestinal microbiota in 30 patients (only UHToulouse)
|
6 months
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Christophe Bureau, MD PhD、University Hospital, Toulouse
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Bureau C, Thabut D, Jezequel C, Archambeaud I, D'Alteroche L, Dharancy S, Borentain P, Oberti F, Plessier A, De Ledinghen V, Ganne-Carrie N, Carbonell N, Rousseau V, Sommet A, Peron JM, Vinel JP. The Use of Rifaximin in the Prevention of Overt Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt : A Randomized Controlled Trial. Ann Intern Med. 2021 May;174(5):633-640. doi: 10.7326/M20-0202. Epub 2021 Feb 2.
- Zacharias HD, Kamel F, Tan J, Kimer N, Gluud LL, Morgan MY. Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev. 2023 Jul 19;7(7):CD011585. doi: 10.1002/14651858.CD011585.pub2.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2013年9月1日
初级完成 (实际的)
2017年7月1日
研究完成 (实际的)
2017年7月1日
研究注册日期
首次提交
2013年12月13日
首先提交符合 QC 标准的
2013年12月18日
首次发布 (估计的)
2013年12月19日
研究记录更新
最后更新发布 (实际的)
2026年5月6日
上次提交的符合 QC 标准的更新
2026年4月29日
最后验证
2026年4月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.