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Carvedilol, Endoscopic Variceal Ligation or Combination of Both for Prevention of First Variceal Bleed in Child's B & C Cirrhosis

Not Applicable
Conditions
Cirrhosis
Interventions
Procedure: Endoscopic Variceal Ligation
Registration Number
NCT03069339
Lead Sponsor
Institute of Liver and Biliary Sciences, India
Brief Summary

Study Design: Open labeled randomized controlled trial. The study will be conducted on patients attending outpatient or admitted to admitted to Department of Hepatology from January 2017 to December 2018 at ILBS, New Delhi

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
330
Inclusion Criteria
  • Liver Cirrhotics between 18-70 yrs of age (cirrhosis diagnosed on the basis of clinical, biochemical, fibroscan & imaging.)
  • CTP ≥ 7-15 (Child's B/C)
  • Small esophageal varices with RCS and large esophageal varices (>5 mm)
  • No history of previous bleed
Exclusion Criteria
  • Malignancy-HCC, PVT
  • Child A
  • MELD >35
  • Contraindications to β blockers.
  • Platelet count < 30,000/mm3
  • Previous endoscopic variceal treatment. (Beyond 21 days)
  • Patients having an indication for TIPS or requiring more than 1 therapeutic ascitic tapping/month
  • Post TIPS, Shunt surgery
  • Acute kidney injury (Sr.Cr>1.5mg/dl)
  • Non cirrhotic portal hypertension
  • Acute on chronic liver failure

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Carvedilol+EVLEndoscopic Variceal Ligation-
CarvedilolCarvedilol-
EVLEndoscopic Variceal Ligation-
Carvedilol+EVLCarvedilol-
Primary Outcome Measures
NameTimeMethod
Reduction in the incidence of first variceal bleed at 1 year.1 year
Secondary Outcome Measures
NameTimeMethod
Improvement in Model for End Stage Liver Disease (MELD) score in all the 3 groups1 year
Incidence of Acute Kidney Injury (AKI) in all the 3 groups1 year
Improvement in Child-Turcotte-Pugh (CTP) score in all the 3 groups1 year
Bleed related Survival in all the 3 groups1 year
HVPG response at 1year in all the 3 groups1 year
Incidence of Shock in all the 3 groups1 year
Treatment related side effects in all the 3 groups1 year
Overall and bleed related Survival in all the 3 groups1 year
Incidence of Spontaneous Bacterial Peritonitis (SBP) in all the 3 groups1 year
Incidence of new ascites in all the 3 groups1 year

Trial Locations

Locations (1)

Institute of liver and Biliary Sciences

🇮🇳

New Delhi, Delhi, India

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