Effect and Safety of Oral Vancomycin in Primary Sclerosing Cholangitis Patients

• Sponsor: Tehran University of Medical Sciences
• Information provided by (Responsible Party): Nasser Ebrahim Daryani, Tehran University of Medical Sciences

Study Description

Brief Summary:

Primary sclerotic cholangitis (PSC) is an inflammatory process of sclerotic cholangitis that involves intra and extra hepatic biliary system. There is no curative treatment for this disorder. Supportive and conservative treatments are the most common therapies that used for this disease. Although treatments such as ursodeoxycholic acid (UDCA) are recommended in some situations but whereas a hypothesis is stimulatory effect of intestinal anaerobic bacteria such as cholestridium difficile as pathogenesıs of PSC, so use of antibiotics is recommended for treatment of these patients. Therefore according to the great role of anaerobic bacteria such as cholestridium difficile in pathogenesis, antibiotics such as metronidazole and vancomycin can be counted as recommended therapies in PSC. In addition some studies correlated this effect of vancomycin to its immunomudulatory effect the cause reduction of inflammation in biliary system. But with all this detail there is no finality about effectiveness of antibiotic therapy and accordingly in this study the investigators compare oral vancomycin effect versus placebo in primary sclerosing cholangitis patients.

In this double blind clinical trial 30 primary sclerosing cholangitis patients that divided in two 15 persosns group with Block Randomization method. in this study one group receive 250 mg oral vancomycin every 6 hours and other group receive placebo.

The study duration is 12 weeks . The baseline laboratory tests and 1 month and 3 months after treatment concept of; Alkaline phosphatase, ALT, AST, GGT and serum total bilirubin and clinical manifestations such as tiredness, itching and probable adverse effects such as hypotension accompanied by flushing,erythematous rash on face and upper body (red neck or red man syndrome), chills and drug fever, eosinophilia and reversible neutropenia.

Condition or disease	Intervention/treatment	Phase
Primary Sclerosing Cholangitis	Drug: Vancomycin; Drug: Placebo	Phase 4

Study Design

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Study Type :	Interventional (Clinical Trial)
Estimated Enrollment :	30 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose:	Treatment
Official Title:	Evaluation of Effectiveness and Safety of Oral Vancomycin in Treatment of Primary Sclerosing Cholangitis.
Study Start Date :	September 2015
Estimated Primary Completion Date :	February 2016
Estimated Study Completion Date :	February 2016

Arms and Interventions

Arm	Intervention/treatment
Experimental: Vancomycin; Vancomyicn 250 mg every 6 hours for 12 weeks	Drug: Vancomycin; Vancomycin for treatment of primary sclerosing cholangitis; Other Name: Vancomycin hydrochloride,
Placebo Comparator: Placebo; placebo every 6 hours for 12 weeks	Drug: Placebo; Placebo for control Group of primary sclerosing vhlangitis

Outcome Measures

Primary Outcome Measures :

1. comparison of laboratory data Alkalyne phosphatase between baseline and after treatment [ Time Frame: 12 weeks ]
   Alkaline phosphatase
2. comparison of laboratory data ALT between baseline and after treatment [ Time Frame: 12 weeks ]
   ALT
3. comparison of laboratory data AST between baseline and after treatment [ Time Frame: 12 weeks ]
   AST
4. comparison of laboratory data GGT between baseline and after treatment [ Time Frame: 12 weeks ]
   GGT
5. comparison of laboratory data serum total bilirubin between baseline and after treatment [ Time Frame: 12 weeks ]
   serum total bilirubin
6. baseline data [ Time Frame: baseline ]
   serum Albumin

Secondary Outcome Measures :

1. Number of participants with adverse events [ Time Frame: 12 weeks ]
   clinical manifestations such as tiredness, itching and probable adverse effects such as hypotension accompanied by flushing,erythematous rash on face and upper body (red neck or red man syndrome), chills and drug fever, eosinophilia and reversible neutropenia.

Eligibility Criteria

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Ages Eligible for Study:	18 Years to 60 Years (Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

1. primary sclerosing chollangitis diagnosis more than 3 months
2. inflammatory bowel disease with cholestasis diagnosis more than 3 months
3. confirmed RCPM
4. confirmed pathology of inflammatory bowel disease

Exclusion Criteria:

1. signs of uncompensated cirrhosis like: hepatic encephalopathy, esophageal varices bleeding
2. gastrointestinal cancer or hepatic cancer
3. immunosuppressive agent using for hepatic problem (not vancomycine hypersensitivity)

Contacts and Locations

Contacts

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Contact: Naser Ebrahimi Daryani, Professor	+989121104517	nasere@yahoo.com
Contact: Zahra Azizi, MD	+989121308409	zahra.azizi1990@gmail.com

Locations

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Iran, Islamic Republic of
Imam khomeini Hospital Complex	Recruiting
Tehran, Iran, Islamic Republic of, 1419733141
Contact: Naser Ebrahimi Daryani, Professor +989121104517 nasere@yahoo.com

Sponsors and Collaborators

Tehran University of Medical Sciences

Investigators

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Principal Investigator:	Shahab Rahimpour, fellowship	Tehran University of Medical Sciences
Study Director:	Mohammad Kazem NouriTaromlou, M.D.	Tehran UMS
Study Director:	Naser Ebrahimi Daryani, Professor	Tehran University of Medical Sciences
Study Director:	Sanam Javidanbardan, M.D.	Tehran University of Medical Sciences
Study Director:	Zahra Azizi, M.D.	Tehran University of Medical Sciences
Study Director:	Mohsen Nasiri Toosi, Professor	Tehran University of Medical Sciences

More Information

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Responsible Party:	Nasser Ebrahim Daryani, Professor, Tehran University of Medical Sciences
ClinicalTrials.gov Identifier:	NCT02605213 History of Changes
Other Study ID Numbers:	9311366004
First Posted:	November 16, 2015
Last Update Posted:	November 16, 2015
Last Verified:	November 2015

Additional relevant MeSH terms:

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Cholangitis; Cholangitis, Sclerosing; Bile Duct Diseases; Biliary Tract Diseases	Digestive System Diseases; Vancomycin; Anti-Bacterial Agents; Anti-Infective Agents