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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04983108
Other study ID # ILBS-ACLF-07
Secondary ID
Status Completed
Phase
First received
Last updated
Start date September 18, 2021
Est. completion date September 30, 2022

Study information

Verified date April 2023
Source Institute of Liver and Biliary Sciences, India
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Monitoring and Assessment: Transient Elastography will be performed in morning hours using the FibroScan apparatus (Echosens), which consists of a 5-MHz ultrasound transducer probe mounted on the axis of a vibrator. The tip of the transducer (M-or XL probe) will be covered with a drop of gel and placed perpendicularly in the intercostal space, with the patient lying in dorsal decubitus position with the right arm in the maximal abduction. Under control, in time motion and in A-mode, the operator will choose a liver portion within the right liver lobe, at least 6-cm thick and free of large vascular structures, and the gallbladder. Liver stiffness (LS) will be measured on a cylinder of hepatic tissue of 1 cm of diameter and 4 cm of length. For assessing the splenic stiffness (SS), the patient will be in supine position with left arm in maximum abduction. Ultrasonography will be used to identify and locate the spleen parenchyma, to choose the right place for SS measurement, and to measure the spleen diameter (long axis). Transducer will be placed in the left intercostal spaces, with location indicated by the ultrasound. A median value of 10 successful acquisitions, expressed in kPa, will be kept as a representative of the LS and SS measurements. The LS and SS measurement failure will be recorded when no value will be obtained after at least 10 shots. The results will be considered unreliable in the following circumstances: valid shots fewer than 10, success rate < 60%, or interquartile range / LS >30 %. Liver and splenic stiffness, LSPS score (LS measurement × spleen diameter / platelet count), Platelet count to spleen diameter ratio (PSR) will be calculated. Patient will also undergo upper g.i. endoscopy on same day. HVPG and TJLB will be done if indicated. The study will assess whether the stiffness scores correlate with presence of esophageal varices. Optimum cutoffs will be calculated for predicting the presence of esophageal varices. - Study design: A Cross-Sectional Study - Study period: 12 months - Sample size with justification: Consecutive Patients of ACLF from approval of study to 12 months. ACLF patients will be screened and eligible patients will be taken in to the study. - Intervention: Patients of ACLF will undergo upper g.i. endoscopy, liver and splenic stiffness measurement. HVPG and TJLB will be done in the patients only if clinically indicated.


Recruitment information / eligibility

Status Completed
Enrollment 216
Est. completion date September 30, 2022
Est. primary completion date September 30, 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years to 70 Years
Eligibility Inclusion Criteria: - Patients of ACLF (APASL criteria). Exclusion Criteria: 1. Age < 18 and > 70 years 2. moderate to severe ascites 3. Portal Vein Thrombosis 4. Hepatocellular carcinoma 5. space occupying lesion liver 6. heart failure 7. biliary obstruction 8. prior variceal endotherapy or ongoing beta blocker treatment for varices 9. pregnancy 10. ICD / pacemaker 11. ongoing treatment for HBV 12. HCV or ended within 3 months 13. No consent.

Study Design


Intervention

Other:
No Intervention
No intervention. This is an observational Study

Locations

Country Name City State
India Institute of Liver & Biliary Sciences New Delhi Delhi

Sponsors (1)

Lead Sponsor Collaborator
Institute of Liver and Biliary Sciences, India

Country where clinical trial is conducted

India, 

Outcome

Type Measure Description Time frame Safety issue
Primary To assess the utility of liver and splenic stiffness and develop a model to predict presence of esophageal varices needing treatment in patients of ACLF. Utility will be find out from the cut off values of ROC with maximum sensitivity. Day 1
Secondary To study the correlation of liver and splenic stiffness with grade of esophageal varices. Day 1
Secondary To study utility of liver and splenic stiffness in evaluating esophageal varices in comparison with other non-invasive tests. Day 1
Secondary To study correlation of liver and splenic stiffness with HVPG in patients of ACLF. Day 1
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