Lactulose for the Prevention of Hepatic Encephalopathy in Cirrhotic Patients With Upper Gastrointestinal Hemorrhage - Full Text View

Sponsored by:	Aga Khan University
Information provided by:	Aga Khan University
ClinicalTrials.gov Identifier:	NCT00553423

Purpose

To evaluate the role of lactulose in prevention of clinically overt hepatic encephalopathy (HE) in the setting of acute upper gastrointestinal bleeding in cirrhotic patients

Condition	Intervention	Phase
Hepatocerebral Encephalopathy Portal-Systemic Encephalopathy Encephalopathy, Hepatic Encephalopathy, Hepatocerebral	Drug: Lactulose Drug: Placebo	Phase III

MedlinePlus related topics: Gastrointestinal Bleeding

Drug Information available for: Lactulose

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Prevention, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Parallel Assignment, Efficacy Study
Official Title:	Randomized Double Blind Placebo Controlled Trial of Lactulose for the Prevention of Hepatic Encephalopathy in Cirrhotic Patients With Upper Gastrointestinal Hemorrhage

Further study details as provided by Aga Khan University:

Primary Outcome Measures:

Development of Clinically Overt Hepatic Encephalopathy [ Time Frame: 48hours ]

Secondary Outcome Measures:

Death, hospital stay [ Time Frame: 48hrs ]

Estimated Enrollment:	128
Study Start Date:	November 2007
Estimated Study Completion Date:	November 2008

Arms	Assigned Interventions
1: Experimental Lactulose 30 ml q6h for 48 hrs	Drug: Lactulose Lactulose 30 ml q6h for 48 hrs
2: Placebo Comparator Placebo 30 ml q6 hrly for 48hrs	Drug: Placebo Placebo 30 ml q6hrly for 48 hrs

Detailed Description:

Variceal hemorrhage occurs in 25 to 35 % of patients with cirrhosis and accounts for 80 to 90% of bleeding episodes in these patients. Around 25-30 percent of patients develop hepatic encephalopathy. Development of hepatic encephalopathy in patients with gastrointestinal bleed can cause increase morbidity with higher hospital costs in these patients. To date no randomized trial has been done in terms of prevention of encephalopathy in gastrointestinal hemorrhage. One trial has compared lactulose in combination with antibiotic against mannite, showed equal efficacy in both groups. No study has been done evaluate the efficacy of lactulose in prevention of encephalopathy in these patients.

We hypothesize that prophylactic use of Lactulose decreases the risk of development of hepatic encephalopathy with upper GI bleed in cirrhotics.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Age >18 years
All acute gastrointestinal bleeding in cirrhotics without hepatic encephalopathy at the time of admission in ER

Exclusion Criteria:

Increased α-fetoprotein level/ Documented hepatoma
Portal or hepatic vein thrombosis
Large-volume or tense ascites requiring repeated therapeutic paracentesis
Serious recurrent or ongoing co morbid illness (e.g., severe renal, cardiac, or respiratory failure; sepsis)
Pregnancy
Not willing to give consent to participate in the study
Patients who are unable to read and write
ER arrival time > 12 hrs from index bleed

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00553423

Contacts

Contact: Shahid Majid, FCPS	9221-4930051 ext 4447	shahid.majid@aku.edu
Contact: Mohammad Salih, FCPS	9221-4930051 ext 4528	mohammad.salih@aku.edu

Locations

Pakistan, Sind
Aga Khan university	Not yet recruiting
Karachi, Sind, Pakistan, 74800
Contact: Shahid Majid, FCPS 9221-4930051 ext 4447 shahid.majid@aku.edu
Contact: Mohammad Salih, FCPS 9221-4930051 ext 4528 mohammad.salih@aku.edu
Principal Investigator: Shahid Majid, FCPS
Sub-Investigator: Mohammad Salih, FCPS
Sub-Investigator: Shahid Ahmed, FCPS
Sub-Investigator: Wasim Jafri, FRCP, FACG
Aga Khan University	Recruiting
Karachi, Sind, Pakistan, 74800
Contact: Shahid Majid, FCPS 9221-4930051 ext 4447 shahid.majid@aku.edu
Contact: Mohammad Salih, FCPS 9221-4930051 ext 4528 mohammad.salih@aku.edu

Sponsors and Collaborators

Aga Khan University

Investigators

Principal Investigator:	Shahid Majid, FCPS	Aga Khan University
Study Director:	Mohammad Salih, FCPS	Aga Khan University
Study Director:	Shahid Ahmed, FCPS	Aga Khan University
Study Chair:	Wasim Jafri, FCPS	Aga Khan University

More Information

No publications provided

Study ID Numbers:	06GS013MED
Study First Received:	November 2, 2007
Last Updated:	November 2, 2007
ClinicalTrials.gov Identifier:	NCT00553423 History of Changes
Health Authority:	Pakistan: Research Ethics Committee

Study placed in the following topic categories:

Liver Diseases
Neurotoxicity Syndromes
Gastrointestinal Diseases
Brain Damage, Chronic
Disorders of Environmental Origin
Hemorrhage
Brain Diseases
Signs and Symptoms
Mental Disorders
Brain Injuries
Dementia
Metabolic Disorder
Neurobehavioral Manifestations
Lactulose
Hepatic Insufficiency

Delirium
Liver Failure
Metabolic Diseases
Poisoning
Gastrointestinal Hemorrhage
Central Nervous System Diseases
Confusion
Encephalitis
Cognition Disorders
Virus Diseases
Hepatic Encephalopathy
Digestive System Diseases
Delirium, Dementia, Amnestic, Cognitive Disorders
Central Nervous System Infections
Neurologic Manifestations

Additional relevant MeSH terms:

Liver Diseases
Neurotoxicity Syndromes
Gastrointestinal Diseases
Brain Damage, Chronic
Disorders of Environmental Origin
Central Nervous System Viral Diseases
Hemorrhage
Brain Diseases
Signs and Symptoms
Pathologic Processes
Mental Disorders
Therapeutic Uses
Neurobehavioral Manifestations
Lactulose
Hepatic Insufficiency

Delirium
Liver Failure
Metabolic Diseases
Nervous System Diseases
Gastrointestinal Agents
Poisoning
Gastrointestinal Hemorrhage
Central Nervous System Diseases
Confusion
Pharmacologic Actions
Encephalitis
Virus Diseases
Hepatic Encephalopathy
Digestive System Diseases
Delirium, Dementia, Amnestic, Cognitive Disorders

ClinicalTrials.gov processed this record on May 06, 2009