Short Course Terlipressin for Control of Acute Variceal Bleeding
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Purpose
The purpose of this study is to determine whether 24 hours of Terlipressin is as effective as 72 hours of Terlipressin in preventing re-bleed once esophageal variceal bleed has been controlled with endoscopic therapy (variceal band ligation or sclerotherapy) in low to moderate risk variceal bleed patients and hence can save cost and may decrease length of hospital stay especially in the I.C.U or high dependency units.
| Condition | Intervention | Phase |
|---|---|---|
|
Hemorrhage Esophageal Varices Portal Hypertension |
Drug: Terlipressin Drug: Terlipressin & then Dummy |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Randomized Double Blind Dummy Controlled Trial Of 24 Versus 72 Hours Of Terlipressin As An Adjuvant Therapy In Acute Variceal Bleed |
- Variceal Re-bleed [ Time Frame: 120 hours (5 Days) ] [ Designated as safety issue: Yes ]
- All cause 30 days mortality [ Time Frame: 30 days ] [ Designated as safety issue: No ]
- 30 days rebleed [ Time Frame: 30 days from index bleed ] [ Designated as safety issue: No ]
- Safety of Terlipressin [ Time Frame: In Hospital safety ] [ Designated as safety issue: Yes ]
| Enrollment: | 130 |
| Study Start Date: | August 2006 |
| Study Completion Date: | August 2008 |
| Primary Completion Date: | July 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
72 hours of Terlipressin
|
Drug: Terlipressin
2 mg Terlipressin stat, then 1 mg q6h for total of 72 hours
Other Name: Novapressin
|
|
Placebo Comparator: 2
24 hours of Terlipressin & then next 48 hours of Dummy of Terlipressin
|
Drug: Terlipressin & then Dummy
2 mg Terlipressin stat then 1 mg q6 hours for 24 hours, then a Dummy of Terlipressin q6 hours for the next 48 hours.
Other Name: Novapressin
|
Detailed Description:
The esophageal variceal bleeding is usually controlled with endoscopic treatment of variceal band ligation or sclerotherapy along with vasoactive drugs like Terlipressin or Octreotide. The risk of re-bleeding is highest during the initial 5 days from first presentation. Terlipressin is usually given for 3 days (72 hours). In this study we are trying to prove that among low to moderate risk patients, a short course of 1 day (24 hours) of Terlipressin is as effective as 3 days (72 hours) in preventing re-bleed once bleeding has been controlled with endoscopic therapy. This intervention will save 2 days cost incurred on the Terlipressin and may also help in decreasing the length of hospital stay in future.
Eligibility| Ages Eligible for Study: | 18 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Acute esophageal variceal bleed
- Liver cirrhosis
- Child's score </= 11
Exclusion Criteria:
- Patient on Mechanical ventilator and or ionotropic support
- Active angina, Recent Myocardial infarction or dynamic EKG changes
- Failure to control variceal bleed on initial endoscopy
- Gastric variceal bleed
- Spontaneous bacterial peritonitis at presentation
- Hepatocellular carcinoma or other liver metastatic malignancy
- Portal vein thrombosis
Contacts and Locations| Pakistan | |
| The Aga Khan University Hospital | |
| Karachi, Sindh, Pakistan, 74800 | |
| Study Chair: | Saeed S Hamid, FRCP, FACG | The Aga Khan University Hospital |
| Study Director: | Zahid SM Azam, MBBS, FCPS | The Aga Khan University Hospital |
| Study Director: | Wasim SM Jafri, FRCP, FACG | The Aga Khan University Hospital |
More Information
No publications provided
| Responsible Party: | Ethical Review Committee (ERC), The Aga Khan University |
| ClinicalTrials.gov Identifier: | NCT00369694 History of Changes |
| Other Study ID Numbers: | 446-Med/ERC-05 |
| Study First Received: | August 24, 2006 |
| Last Updated: | September 24, 2008 |
| Health Authority: | Pakistan: Research Ethics Committee |
Keywords provided by Aga Khan University:
|
Esophageal varices Portal Hypertension Melena Hematemesis |
Gastrointestinal Hemorrhage Terlipressin Efficacy Safety |
Additional relevant MeSH terms:
|
Esophageal Diseases Esophageal and Gastric Varices Hemorrhage Hypertension Hypertension, Portal Varicose Veins Gastrointestinal Diseases Digestive System Diseases Liver Diseases Pathologic Processes Vascular Diseases Cardiovascular Diseases Terlipressin |
Lypressin Vasoconstrictor Agents Cardiovascular Agents Therapeutic Uses Pharmacologic Actions Antihypertensive Agents Antidiuretic Agents Natriuretic Agents Physiological Effects of Drugs Hemostatics Coagulants Hematologic Agents |
ClinicalTrials.gov processed this record on May 19, 2013