the Efficiency of Thalidomide for Recurrent Small Intestinal Bleeding Due to Gastrointestinal Vascular Malformation
- Conditions
- Gastrointestinal Vascular Malformation
- Interventions
- Registration Number
- NCT02707484
- Lead Sponsor
- Shanghai Jiao Tong University School of Medicine
- Brief Summary
Gastrointestinal vascular malformation (GIVM), which is an important cause of acute or chronic gastrointestinal bleeding, currently lacks of effective treatment. The investigators' previous study first confirmed thalidomide treatment of GIVM bleeding was safe and effective. This prospective multi-center randomized controlled clinical trial intends to investigate the efficacy of thalidomide to the recurrent small intestinal hemorrhage due to GIVM.
- Detailed Description
This multi-institutional clinical trial investigates the efficacy of thalidomide to the recurrent small intestinal hemorrhage due to GIVM. Patients with annual average bleeding 4 times or more and lesions located in the small intestine which are not suitable for endoscopic therapy will be randomly assigned to receive A(25mg,Thalidomide，qid), B(25mg, Thalidomide, bid\& placebo bid ) or placebo(deferred treatment group) for 4 months. The primary endpoints were the effective response of patients with ≥50% reduction of numbers of bleeding episodes, followed by rate of cases with cessation of bleedin, the difference in blood transfusion, hospitalization, transfusion volume of red cell, average bleeding duration, average hemoglobin level, yearly hospitalization times, average hospital stay and yearly bleeding episodes. This study will be done at 10 centers in China.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 150
- Subjects voluntarily signed the informed consent after the nature and the specific procedures of the trial has been verbally explained; they have the opportunity to ask questions.
- Chinese nationality;
- Female or male subjects aged 18-75 years. Female subjects must be menopausal or have undergone sterilization such as tubal ligation and hysterectomy, or have no plan to give birth recently and agree to take contraceptive measures such as contraceptive drugs, intrauterine physical birth control rings or contraception condoms; or men must have undergone sterilization or do not plan to have a child recently and agree to take contraceptive measures such as contraceptive drugs, or contraception condoms. These criteria are set to eliminate the risk of subjects of child bearing potential.
- The subjects must have been diagnosed, by capsule endoscopy and / or balloon-assisted enteroscopy, with small intestinal vascular malformation lesions which are unsuitable or inaccessible to endoscopic therapy or surgical antrectomy. Subjects with persistent, recurrent bleeding, ≥ 4 episodes of overt or occult bleeding over last year.
- Subjects with esophageal varices from cirrhosis of the liver; those with uncontrolled hypertension or hyperglycemia (or diabetics who are being treated with insulin), or those with severe heart (e.g., uncontrolled angina pectoris and / or myocardial infarction, congestive heart failure, etc.), respiratory failure, or renal failure with creatinine (Cr) or blood urea nitrogen (BUN) > 2 times the upper limit of normal (ULN), pancreatic or hepatic disease with abnormal hepatic function with alanine aminotransferase (ALT), aspartate aminotransferase (AST) or total bilirubin (TBil) > 2 times ULN 3 months before the enrollment, or those with any other diseases that are not suitable for the study as judged by the Investigator;
- Subjects with a history of severe peripheral neuropathy or seizures, or a history of thromboembolic disease;
- Subjects who need to continuously use non-steroidal anti-inflammatory drugs, anticoagulants, antiplatelets, acetylsalicylic acid preparations, or Chinese herbal medicines containing ginkgo and echinacea; or those who need to receive other anti-angiogenic drugs for a long time;
- Subjects with white blood cell counts persistently <3.5 * 10^9 / L;
- Subjects with a history of small bowel resection;
- Subjects known or suspected to be allergic to any component of thalidomide；
- Subjects with severe gastrointestinal bleeding that is life-threatening and requires immediate surgical treatment;
- Subjects who have previously received thalidomide for gastrointestinal bleeding 30 days before the enrollment;
- Alcohol and / or substance abusers with addiction or dependence, or those with poor compliance as judged by a doctor;
- Subjects who participated in other clinical trial 6 months before enrollment;
- Subjects without legal capacity or self-awareness.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description placebo -controlled Group placebo Generic name:Thalidomide Placebo Dosage form:tablet, Placebo Dosage:Placebo Frequency: Placebo, QID, Oral Duration:120 days Thalidomide Group（100mg） Thalidomide (100mg) Generic name:Thalidomide Dosage form:tablet, 25mg Dosage:100mg/day Frequency: 25mg, QID, Oral Duration:120 days Thalidomide Group（50mg） Thalidomide (50mg) Generic name:Thalidomide Dosage form:tablet, 25mg\&Placebo Dosage:50mg/day Frequency: 25mg BID \&Placebo, BID, Oral Duration:120 days
- Primary Outcome Measures
Name Time Method effective response rate First 1-year follow-up versus the 1-year Observation Period. the proportion of patients with "effective treatment, patients with ≥50% reduction of numbers of bleeding episodes after treatment during the First 1-year follow-up versus the 1-year Observation Period.
- Secondary Outcome Measures
Name Time Method rate of cases requiring blood transfusion First 1-year follow-up versus the 1-year Observation Period. The rate of cases requiring blood transfusion during the First 1-year follow-up.
change in the transfusion volume of red cell First 1-year follow-up versus the 1-year Observation Period. The change in the transfusion volume of red cell during the First 1-year Follow-up Period versus the Observation Period.
change in yearly hospitalization times First 1-year follow-up versus the 1-year Observation Period. The change in yearly hospitalization times due to bleeding during the First 1-year Follow-up Period versus the Observation Period.
change in average hospital stay First 1-year follow-up versus the 1-year Observation Period. The change in average hospital stay (days)due to bleeding during the First 1-year Follow-up Period versus the Observation Period.
change in yearly bleeding episodes First 1-year follow-up versus the 1-year Observation Period. The change in yearly bleeding episodes during the First 1-year Follow-up Period versus the Observation Period.
overall rate of cases with cessation of bleeding First 1-year follow-up versus the 1-year Observation Period. The overall rate of cases with cessation of bleeding without rebleeding during the First 1-year Follow-up Period.
rate of cases requiring hospitalizations due to bleeding First 1-year follow-up versus the 1-year Observation Period. The rate of cases requiring hospitalizations due to bleeding during the 1st 1-year follow-up
change in average bleeding duration First 1-year follow-up versus the 1-year Observation Period. The change in average bleeding duration (days) during the First 1-year Follow-up Period versus the Observation Period.
change in average hemoglobin level First 1-year follow-up versus the 1-year Observation Period. The change in average hemoglobin level (g/L) during the First 1-year Follow-up Period versus the Observation Period.
Trial Locations
- Locations (10)
Peking Union Medical College Hospital
🇨🇳Beijing, Beijing, China
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
🇨🇳Shanghai, Shanghai, China
Xinqiao Hospital of Chongqing
🇨🇳Chongqing, Chongqing, China
Nanfang Hospital of Southern Medical University
🇨🇳Guangzhou, Guangdong, China
Ruijin Hospital
🇨🇳Shanghai, Shanghai, China
Shanghai Zhongshan Hospital
🇨🇳Shanghai, Shanghai, China
Huashan Hospital
🇨🇳Shanghai, Shanghai, China
Changhai Hospital
🇨🇳Shanghai, Shanghai, China
Department of Gastroenterology, Renji Hospital, Shanghai Institute of Digestive Diseases, Shanghai Jiao Tong University School of Medicine
🇨🇳Shanghai, Shanghai, China
Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
🇨🇳Shanghai, Shanghai, China