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Primary Antibiotic Prophylaxis Using Co-trimoxazole to Prevent Spontaneous Bacterial Peritonitis in Cirrhosis

Phase 3
Active, not recruiting
Conditions
Spontaneous Bacterial Peritonitis
Interventions
Drug: Co-Trimoxazole 960Mg Dispersible Tablet
Drug: Placebo oral tablet
Registration Number
NCT04395365
Lead Sponsor
University College, London
Brief Summary

A multicentre, interventional, double-blind, placebo-controlled, parallel-arm, phase 3, randomised controlled trial to evaluate the use of co-trimoxazole as primary prophylaxis for spontaneous bacterial peritonitis to improve overall survival

Detailed Description

See above

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
442
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Co-trimoxazoleCo-Trimoxazole 960Mg Dispersible TabletCo-trimoxazole, 960mg capsule oral tablet, to be taken daily for 18 months
PlaceboPlacebo oral tabletPlacebo, 960mg capsule oral tablet, to be taken daily for 18 months
Primary Outcome Measures
NameTimeMethod
Overall SurvivalThe maximum possible period of follow up will be 48 months (assuming a recruitment period of 30 months and 18 months treatment period for final patient recruited)

Overall Survival

Secondary Outcome Measures
NameTimeMethod
Infections other than spontaneous bacterial peritonitis with hospital admissionMinimum period of 18 months from randomisation

Incidence of infections other than spontaneous bacterial peritonitis with hospital admission.

Spontaneous Bacterial peritonitisMinimum period of 18 months from randomisation

Time to first incidence of spontaneous bacterial peritonitis (SBP)

Hospital admissionsMinimum period of 18 months from randomisation

Hospital admission rates

C. difficile-associated diarrhoeaMinimum period of 18 months from randomisation

Incidence of C. difficile-associated diarrhoea

Cirrhosis related eventsMinimum period of 18 months from randomisation

Incidence of other cirrhosis related events (e.g. variceal haemorrhage)

Renal dysfunctionMinimum period of 18 months from randomisation

Incidence of renal dysfunction with creatinine \>133 μmol/L (1.5mg/dL) at any point during hospital admission

Anti-microbial resistanceMinimum period of 18 months from randomisation

Incidence of anti-microbial resistance

Liver transplantationMinimum period of 18 months from randomisation

Incidence of liver transplantation

Liver disease assessed by increase in MELD scoreMinimum period of 18 months from randomisation

Progression of liver disease assessed by increase in MELD score between baseline and end of trial follow up.

Safety and treatment-related serious adverse eventsMinimum period of 18 months from randomisation

Safety and treatment-related serious adverse events

Treatment adherenceMinimum period of 18 months from randomisation

Treatment adherence (assessed by MARS questionnaire)

Health-related quality of lifeMinimum period of 18 months from randomisation

Health-related quality of life assessed using EQ-5D-5L questionnaire

Mean incremental cost per quality adjusted life year gained (QALY)Minimum period of 18 months from randomisation

Mean incremental cost per quality adjusted life year gained (QALY)

Health and social careMinimum period of 18 months from randomisation

Health and social care resource use assessed using Hospital Episode Statistics (HES) database

Incidence of resolution of ascites with diuretic treatment not required for 6 monthsMinimum period of 18 months from randomisation

Incidence of resolution of ascites with diuretic treatment not required for 6 months

Transjugular intrahepatic portosystemic shunt (TIPS) insertionMinimum period of 18 months from randomisation

Incidence of Transjugular intrahepatic portosystemic shunt (TIPS) insertion

Trial Locations

Locations (1)

Royal Free hospital

🇬🇧

Hampstead, London, United Kingdom

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