Home
Search
Study Topics
Glossary
|
|
|
|
|
|
Sponsored by: |
University of Padova |
---|---|
Information provided by: | University of Padova |
ClinicalTrials.gov Identifier: | NCT00742339 |
From 1999, several studies have showed that the use of vasoconstrictors in association with albumin are effective in the treatment of hepatorenal syndrome (HRS). The rationale of the use of vasoconstrictors together with albumin in the treatment of this severe complication of portal hypertension in patients with cirrhosis is to correct the reduction of the effective circulating volume due to the splanchnic arterial vasodilatation.In most of these studies terlipressin, a derivate of vasopressin, has been used as vasoconstrictor as intravenous boluses moving from an initial dose of 0.5-1 mg/4 hr. In some studies midodrine, an alpha-adrenergic agonist, given by mouth has been used as vasoconstrictor at a dose ranging from 2.5 up to 12.5 tid together with octreotide, an inhibitor of the release of glucagon, given subcutaneously at a dose ranging from 10 µg upt to 200 µg tid. To the day, there isn't a study comparing terlipressin + albumin versus midodrine + octreotide + albumin in the treatment of HRS in patients with cirrhosis.Thus, the aim of the study is to compare terlipressin + albumin vs midodrine + octreotide + albumin in the treatment of the HRS in patients with cirrhosis.
Condition | Intervention | Phase |
---|---|---|
Cirrhosis Hepatorenal Syndrome |
Drug: Terlipressin plus albumin Drug: Midodrine plus octreotide plus human albumin |
Phase II Phase III |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study |
Official Title: | Terlipressin + Albumin Versus Midodrine + Octreotide in the Treatment of Hepatorenal Syndrome (HRS): An Open Multicentric Randomized Study |
Estimated Enrollment: | 100 |
Study Start Date: | May 2005 |
Estimated Study Completion Date: | December 2009 |
Estimated Primary Completion Date: | June 2009 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
1: Active Comparator
Fifty patients with cirrhosis and HRS will be randomly assigned to arm 1.
|
Drug: Terlipressin plus albumin
The terlipressin will be give at the initial dose of 3 mg/24 hours by intravenous continuous infusion. If during the following 48 hours the serum value of creatinine will not change or will go down less than 25%, the dose of terlipressin will be increased to 6 mg/24 hours. If no response will ensue, the dose of terlipressin will be increased to the maximal dose of 12 mg/24 hours. Twenty percent human albumin solution will be administrate together with terlipressin at the dosage of 1 g/Kg of body weight, on first day, and then, to the dosage of 20-40 g/Kg in order to maintain the central venous pressure (CVP) between 10 and 15 cm H2O.The treatment with terlipressin and albumin will be maintained for 24 hours after complete or incomplete resolution. The length of the study in patients with complete and incomplete resolution will reach a maximum of 15 days. In the patients without response the treatment with the high dosage of terlipressin will go on for a maximum of 7 days.
|
2: Experimental
Fifty patients with cirrhosis and HRS will be randomly assigned to arm 2.
|
Drug: Midodrine plus octreotide plus human albumin
Midodrine will be give orally at the initial dose 7.5 tid together with octreotide at the initial dosage of 100 µg subcutaneously tid. If during the following 96 hours the serum value of creatinine will not change or will go down less than 25%, the dose of midodrine will be increased to 12.5 mg tid Twenty percent human albumin solution will be administrate together with midodrine and octreotide at the dosage of 1 g/Kg of body weight, on first day, and then, to the dosage of 20-40 g/Kg in order to maintain the central venous pressure (CVP) between 10 and 15 cm H2O.The treatment with terlipressin and albumin will be maintained for 24 hours after complete or incomplete resolution. The length of the study in patients with complete and incomplete resolution will reach a maximum of 15 days. In the patients without response the treatment with the high dosage of terlipressin will go on for a maximum of 7 days.
|
Ages Eligible for Study: | 18 Years to 75 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Paolo Angeli, Md, PhD | +390498218676 | pangeli@unipd.it |
Italy | |
Dept. of Clinical and Experimental Medicine, University of Padova | Recruiting |
Padova, Italy, 35100 | |
Sub-Investigator: Silvano Fasolato, MD |
Responsible Party: | Dept. of Clinical and Experimental Medicine, University of Padova, Italy ( Paolo Angeli, MD, PhD ) |
Study ID Numbers: | 1264P |
Study First Received: | August 26, 2008 |
Last Updated: | August 26, 2008 |
ClinicalTrials.gov Identifier: | NCT00742339 |
Health Authority: | Italy: Ministry of Health |
cirrhosis hepatorenal syndrome terlipressin midodrine octreotide |
human albumin effective circulating volume The criteria which will be used for the diagnosis of HRS will be the criteria which were recently published by the International Ascites Club Patients with cirrhosis and type 2 HRS only with serum creatinine value > 2.5 mg/dl All patients with cirrhosis and type 1 HRS |
Lysine Vasopressin Liver Diseases Fibrosis Benzocaine Octreotide Liver Cirrhosis Arginine Vasopressin Hepatorenal syndrome |
Digestive System Diseases Urologic Diseases Ascites Terlipressin Vasopressins Midodrine Kidney Diseases Hepatorenal Syndrome |
Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Adrenergic Agents Coagulants Antineoplastic Agents Physiological Effects of Drugs Hematologic Agents Adrenergic Agonists Pathologic Processes Syndrome Therapeutic Uses Vasoconstrictor Agents Adrenergic alpha-Agonists |
Disease Antineoplastic Agents, Hormonal Sympathomimetics Gastrointestinal Agents Cardiovascular Agents Antihypertensive Agents Pharmacologic Actions Hemostatics Autonomic Agents Natriuretic Agents Peripheral Nervous System Agents Antidiuretic Agents |