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Intestinal Decontamination With Rifaximin. The Inflammatory and Circulatory State in Patients With Cirrhosis

This study has been completed.
Region MidtJylland Denmark
Statens Serum Institut
Information provided by (Responsible Party):
Nina Kimer, Copenhagen University Hospital, Hvidovre Identifier:
First received: January 8, 2013
Last updated: January 18, 2016
Last verified: January 2016

This investigational trial will be assessing the effect of rifaximin on pathophysiology and haemodynamics in the patient with liver cirrhosis, and addressing the effect of rifaximin on several organs on marker level. The molecular and physiological effects of rifaximin will be explored.

The investigators hypothesize that intestinal decontamination with rifaximin in patients with cirrhosis and ascites will interrupt bacterial translocation from the gut, diminish the following inflammatory response, prevent splanchnic vasodilatation and portal systemic contraction and thereby reduce the risk clinical complications to cirrhosis.

If rifaximin can correct small intestinal bacterial overgrowth and demonstrate improvement in liver haemodynamics, renal function and systemic dynamics, then these effects may contribute to the overall well-being of the patient and prevent complications to the underlying cirrhosis such as risk of infections, progression of disease, and admission to hospital.

Condition Intervention Phase
Liver Cirrhosis Ascites Drug: Rifaximin Drug: placebo Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Basic Science
Official Title: Intestinal Decontamination With Rifaximin. Effects on the Inflammatory and Circulatory State in Patients With Cirrhosis and Ascites - A Randomised Controlled Clinical Study

Resource links provided by NLM:

Further study details as provided by Nina Kimer, Copenhagen University Hospital, Hvidovre:

Primary Outcome Measures:
  • Change from baseline in Hepatic venous pressure gradient (HVPG) [ Time Frame: 29 days ]
    Evaluation of a change in HVPG where values at baseline are compared to values after treatment at 29 days.

Secondary Outcome Measures:
  • Change from baseline in Glomerular filtration rate (GFR) [ Time Frame: 29 days ]
    Assessment of a change in GFR from baseline until after treatment, at 29 days

Other Outcome Measures:
  • Change from baseline of inflammatory markers (TNF-alpha, interleukins, etc.) [ Time Frame: day 29 ]
    Inflammatory markers measured in arterial blood before and after intervention.

  • Change from baseline of potential small intestinal bacterial overgrowth [ Time Frame: days 28-30 ]
    Assessment of bacterial overgrowth by glucose breath test and bacterial DNA in blood and stool.

  • six-month mortality and comorbidity [ Time Frame: 180 days ]

Enrollment: 54
Study Start Date: November 2012
Study Completion Date: January 2016
Primary Completion Date: January 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Rifaximin
Rifaximin tablets for oral ingestion, 550 mg twice daily for 28 days.
Drug: Rifaximin
550 mg two times daily for 28 days
Other Name: Xifaxan
Placebo Comparator: Placebo tablets
Placebo tablets similar in shape and size to intervention treatment, 1 tablet twice daily for 28 days.
Drug: placebo

  Show Detailed Description


Ages Eligible for Study:   18 Years to 80 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Decompensated liver cirrhosis and clinical signs of ascites
  • Age 18 - 80 years
  • Portal hypertension and hepatic venous pressure gradient (HVPG) of 10 mmHg or more
  • Women of child-bearing age must use safe anticonception, either hormonal anticonception or intrauterine device (IUD)

Exclusion Criteria:

  • Child-Pugh score above 12
  • Clinical signs of infection or biochemical signs of infection with leucocytes > 10x10'9/L and C-Reactive Protein (CRP)> 20 or positive urine culture
  • Hepatocellular carcinoma within the last year
  • Invasive cancer within the last five years
  • Hepatic encephalopathy above grade 1
  • serum creatinine > 200 micromoles/L
  • Transfusion requiring bleeding one week prior to inclusion
  • severe cardiac, pulmonary or kidney disease or IDDM
  • alcohol abuse and symptoms of abstinences
  • Expected survival less than 3 months
  • Denied consent
  Contacts and Locations
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Please refer to this study by its identifier: NCT01769040

Copenhagen University hospital Hvidovre
Hvidovre, Denmark, 2650
Sponsors and Collaborators
Copenhagen University Hospital, Hvidovre
Region MidtJylland Denmark
Statens Serum Institut
Principal Investigator: Nina Kimer, MD Department of Gastroenterology, Cpenhagen University Hospital Hvidovre
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Nina Kimer, MD, Phd-student, Copenhagen University Hospital, Hvidovre Identifier: NCT01769040     History of Changes
Other Study ID Numbers: RifaxNK150612
2012-002890-71 ( EudraCT Number )
Study First Received: January 8, 2013
Last Updated: January 18, 2016

Keywords provided by Nina Kimer, Copenhagen University Hospital, Hvidovre:
Decompensated liver cirrhosis
Small intestinal bacterial overgrowth

Additional relevant MeSH terms:
Liver Cirrhosis
Pathologic Processes
Liver Diseases
Digestive System Diseases
Anti-Infective Agents
Gastrointestinal Agents
Nucleic Acid Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Anti-Bacterial Agents processed this record on June 22, 2017