G-CSF and Erythropoetin in Survival of Patients With Decompensated Liver Disease
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Purpose
Study Design
50 patients will be enrolled and randomized into patients (Group IA) and controls (Group I B)
Investigations:
Hematology CBC, Prothrombin time and INR Peripheral smear, Retics Biochemistry Liver function testing, AFP Kidney function testing Etiology of chronic liver disease Infectious etiology: total antiHBc, anti HCV, HCV RNA, HBV DNA Non infectious etiology: Autoimmune markers, copper studies, iron studies, HOMA IR, FBS Etiology of decompensation Variceal bleed Infection ( blood culture, urine culture, sputum culture, chest xray) Surgery Drugs Alcohol intake Ascitic fluid analysis UGI endoscopy Imaging USG abdomen with Doppler for spleno-portal axis CECT- Triple phase upper abdomen Liver regenerative potential efficacy testing Histology ( by transjugular liver biopsy) Liver Dendritic cells ( CD11c, CD40, CD 54, CD 123, BDCA 2 staining) by flow cytometry CD 34+ cells, CD 45+ cells and CD 133+ cells measurement in hepatic venous blood, peripheral blood and liver biopsy by flow cytometry Markers of proliferation like Ki- 67, proliferating cell nuclear antigen (PCNA) in liver biopsy Markers of angiogenesis like VEGF, v WF in hepatic venous blood Measurement of Hepatic venous pressure gradient ( HVPG)
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Liver Disease |
Drug: G-CSF+EPO Drug: Placebo |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver) Primary Purpose: Treatment |
| Official Title: | A Prospective Randomized Double Blind Trial to Study the Efficacy of G-CSF and Erythropoetin in Survival of Patients With Decompensated Liver Disease |
- transplant free survival at 1 year [ Time Frame: 3 Months ] [ Designated as safety issue: No ]
- transplant free survival at 6 months, histo-pathological evidence of hepatic regeneration and mobilization of CD34/stem cells, improvement in severity assessment indices [ Time Frame: 6 Months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 50 |
| Study Start Date: | July 2011 |
| Estimated Study Completion Date: | August 2013 |
| Estimated Primary Completion Date: | August 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: G-CSF+EPO |
Drug: G-CSF+EPO
Drug: Granulocyte Colony-stimulating Factor (G-CSF) and Erythropoetin (EPO) G-CSF (in prefilled syringe) at a dose of 5 µg/kg s/c at days 1, 2, 3, 4, 5 and then every 3rd day till day 28 (total 12 doses), along with Darbopoetin alpha 100 mcg/ week (in prefilled syringe) for 4 weeks (total 4 doses). Arms: G-CSF+EPO Drug: Placebo Placebo 1 (in prefilled syringe) s/c at days 1, 2, 3, 4, 5 and then every 3rd day till day 28 (total 12 doses), along with Placebo 2 every week (in prefilled syringe) for 4 weeks (total 4 doses). |
| Placebo Comparator: Placebo |
Drug: Placebo
Placebo 1 (in prefilled syringe) s/c at days 1, 2, 3, 4, 5 and then every 3rd day till day 28 (total 12 doses), along with Placebo 2 every week (in prefilled syringe) for 4 weeks (total 4 doses).
|
Eligibility| Ages Eligible for Study: | 12 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- All patients who were known to have cirrhosis of liver with portal hypertension, now decompensated with ascites/ jaundice/ bleed/ HE/ HRS
Exclusion Criteria:
Age <12 or > 75 years
- Autoimmune disorders
- HCC
- Sepsis ( Any culture positive: blood, urine, any other obvious source of infection: UTI, SBP)
- Multi organ failure
- Grade 4 HE
- HIV seropositivity / pregnancy
- Essential Hypertension
- Patients being taken up for transplant
- Refusal to participate in the study
Contacts and Locations| Contact: Ankit Bhardwaj | 011-46300000 | bhardwaj.ankit3@gmail.com |
| India | |
| Institute of liver and Biliary Sciences | Recruiting |
| New Delhi, Delhi, India, 110070 | |
| Contact: Chandan Kumar, MD 011-46300000 <drchandankn@gmail.com>, | |
| Principal Investigator: Chandan Kumar, MD | |
| Study Director: | Shiv Kumar Sarin, MD,DM | Institute of Liver & Biliary Sciences (ILBS) |
More Information
No publications provided
| Responsible Party: | Institute of Liver and Biliary Sciences, India |
| ClinicalTrials.gov Identifier: | NCT01384565 History of Changes |
| Other Study ID Numbers: | ILBS DLD 01 |
| Study First Received: | June 28, 2011 |
| Last Updated: | February 19, 2013 |
| Health Authority: | India: Ministry of Health |
Additional relevant MeSH terms:
|
Liver Diseases Digestive System Diseases Epoetin Alfa Hematinics |
Hematologic Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013