Spironolactone on Fibrosis Progrssion-Portal Hypertension(FP-PH)in Cirrhosis (FP-PH)
Primary Purpose
Cirrhosis, Portal Hypertension
Status
Completed
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
Spironolactone and carvedilol
Carvedilol
Sponsored by
About this trial
This is an interventional prevention trial for Cirrhosis
Eligibility Criteria
Inclusion Criteria:
-Proven cirrhosis based on histology or unequivocal clinical, sonographic and laboratory findings
Exclusion Criteria:
- Treatment with β-blockers or diuretics in the last 3 months
- Severe cardiopulmonary or renal insufficiency
- Chronic alcohol abuse
- Can't tolerate side effects of oral carvedilol or spironolactone
- History of variceal bleeding
- Malignancy
- Portal vein thrombosis
- History of partial splenic embolization or splenectomy
- Moderate or tense ascites
Sites / Locations
- Shanghai Tongji Hospital, Tongji University
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Experimental
Arm Label
Carvedilol
Spironolactone and carvedilol
Arm Description
Carvedilol starts at 6.25mg/d and increases to 12.5mg/d in next week as a maintainence dose
Carvedilol starts at 6.25mg/d and increases to 12.5mg/d in next week as a maintainence dose Spironolactone is added after carvedilol being tolerated, which starts with 20mg/d and increases to 40mg/d as a maintainence dose
Outcomes
Primary Outcome Measures
Virtual portal pressure gradient(vPPG)
Calculated based on reconstructed 3D portal trunk using anatomical information extracted from CT angiography and blood flow velocity measured by Doppler ultrasound
Secondary Outcome Measures
Liver stiffness measurement (LSM)
Detected using FibroScan
Occurence of portal hypertension-related complications
variceal bleeding, ascites, hepatic encephalopathy
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02907749
Brief Title
Spironolactone on Fibrosis Progrssion-Portal Hypertension(FP-PH)in Cirrhosis
Acronym
FP-PH
Official Title
Effects of Spironolactone on Fibrosis Progression and Portal Pressure in Patients With Advanced Chronic Liver Disease
Study Type
Interventional
2. Study Status
Record Verification Date
August 2020
Overall Recruitment Status
Completed
Study Start Date
January 1, 2018 (Actual)
Primary Completion Date
January 1, 2020 (Actual)
Study Completion Date
July 31, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Changqing Yang
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The aim of this study is to investigate the effects of spironolactone on liver fibrosis progression and portal pressure gradient in patients with advanced chronic liver disease. Eligible cirrhosis patients were 2:1 randomized to either combination (carvedilol and spironolactone) or single (carvedilol) therapy group. Changes in virtual portal pressure gradient (vPPG) of portal trunk (calculated based on reconstructed 3D model and measured blood flow velocity), liver stiffness measurement (Fibroscan) and serum markers of liver fibrogenesis were documented at baseline and six months later.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cirrhosis, Portal Hypertension
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
96 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Carvedilol
Arm Type
Active Comparator
Arm Description
Carvedilol starts at 6.25mg/d and increases to 12.5mg/d in next week as a maintainence dose
Arm Title
Spironolactone and carvedilol
Arm Type
Experimental
Arm Description
Carvedilol starts at 6.25mg/d and increases to 12.5mg/d in next week as a maintainence dose
Spironolactone is added after carvedilol being tolerated, which starts with 20mg/d and increases to 40mg/d as a maintainence dose
Intervention Type
Drug
Intervention Name(s)
Spironolactone and carvedilol
Other Intervention Name(s)
Combination therapy
Intervention Description
Patients are treated with carvedilol in combination with spironolactone.
Intervention Type
Drug
Intervention Name(s)
Carvedilol
Other Intervention Name(s)
Single therapy
Intervention Description
Patients are treated with carvedilol only.
Primary Outcome Measure Information:
Title
Virtual portal pressure gradient(vPPG)
Description
Calculated based on reconstructed 3D portal trunk using anatomical information extracted from CT angiography and blood flow velocity measured by Doppler ultrasound
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Liver stiffness measurement (LSM)
Description
Detected using FibroScan
Time Frame
6 months
Title
Occurence of portal hypertension-related complications
Description
variceal bleeding, ascites, hepatic encephalopathy
Time Frame
6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
-Proven cirrhosis based on histology or unequivocal clinical, sonographic and laboratory findings
Exclusion Criteria:
Treatment with β-blockers or diuretics in the last 3 months
Severe cardiopulmonary or renal insufficiency
Chronic alcohol abuse
Can't tolerate side effects of oral carvedilol or spironolactone
History of variceal bleeding
Malignancy
Portal vein thrombosis
History of partial splenic embolization or splenectomy
Moderate or tense ascites
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jing Li, M.D.
Organizational Affiliation
Shanghai Tongji Hospital, Tongji University School of Medicine
Official's Role
Study Director
Facility Information:
Facility Name
Shanghai Tongji Hospital, Tongji University
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
20065
Country
China
12. IPD Sharing Statement
Learn more about this trial
Spironolactone on Fibrosis Progrssion-Portal Hypertension(FP-PH)in Cirrhosis
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