Hepatitis C Virus Recurrence Clinical Trial
Official title:
A Randomized, Double-blind, Placebo-controlled Study to Investigate the Efficacy and Safety of LEGALON SIL for the Treatment of HCV Recurrence in Stable Liver Transplanted Patients
Hepatitis C virus (HCV)-related liver disease is the most common indication for liver transplantation (LT). However, LT does not cure the infection, and therapeutic strategies resulted in very limited efficacy and tolerability in LT recipients. In view of its postulated safety profile, Silibinin seems an ideal drug to be used in the setting of HCV recurrent patients after liver transplantation.
Hepatitis C virus (HCV)-related liver disease continues to be the most common indication for
liver transplantation (LT) in both the United States and Europe. However, LT does not cure
the infection, and re-infection of the liver allograft universally occurs. Recurrent HCV
hepatitis often follows an accelerated course after LT, and histological recurrence occurs
in approximately 50% of patients within 1 year after LT; 15-30% of them develop cirrhosis
within 5 years. In this context, a peculiar feature is represented by the rapid course of
liver fibrosis. Therapeutic strategies for managing the primary cause of liver damage, i.e.
HCV infection, irrespective of application in pre-, peri-, and/or post-LT periods resulted
in very limited efficacy and tolerability in LT recipients.
In view of its postulated safety profile, Silibinin seems an ideal drug to be used in the
setting of HCV recurrent patients after liver transplantation.
Silibinin, a flavonolignan representing the main component (60%) of Silymarin and proposed
as an anti-hepatotoxic agent for the treatment of various liver diseases has been recently
reported to beneficially modulate the pro-fibrogenic potential of HSC, thus representing a
very attractive possibility in the transplanted population. Besides the anti-inflammatory
properties, Silibinin is able to inhibit Tumor necrosis factor-alpha (TNF-α). This is a
proinflammatory cytokine with a major role in both acute and chronic viral, bacterial and
fungal infections.
The primary objective is to determine the effect of post-transplant treatment with Legalon
SIL on HCV viral load 30 days after the beginning of treatment.
44 stable liver transplanted patients with HCV recurrence will be randomized 3:1 to receive
Legalon-SIL or Placebo. Randomized patients will be treated for 14 consecutive days with
Legalon-SIL or Placebo. Patients dropping-out before the end of treatment period will be
replaced.
Patients will be followed up for 1 year to monitor the effect of treatment on liver
fibrosis, liver functional state, lymphocyte activation, and viral load.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment