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Extension Study of Carvedilol RCT Study

Not Applicable
Recruiting
Conditions
Liver Cirrhosis
Portal Hypertension
Interventions
Registration Number
NCT05021406
Lead Sponsor
Beijing Friendship Hospital
Brief Summary

Patients who have completed 2-years treatment in RCT Study of carvedilol will receive another 2-years extension therapy, aiming to investigate the long-term efficacy of carvedilol for the prevention of esophageal varices in treated HBV cirrhotic patients.

Detailed Description

Carvedilol has been shown to be more potent in decreasing portal hypertension than propranolol. But the efficacy of carvedilol to prevent esophageal varices progression in nucleoside analogue (NUCs) treatment HBV related cirrhotic patients was unclear. Previous RCT study aimed to explore the effects of carvedilol for the prevention of the esophageal varices progression on HBV cirrhotic patients with anti-viral therapy has been conducted (NCT03736265). Patients who have completed 2-years treatment in RCT Study of carvedilol will receive another 2-years extension therapy, aiming to investigate the long-term efficacy of carvedilol for the prevention of esophageal varices in treated HBV cirrhotic patients. Patients were allocated according to the outcome of EDGs at 2-year during RCT study. Patients will be assessed at baseline and every six months for blood cell count, liver function test, HBVDNA, AFP, prothrombin time, liver ultrasonography, and Fibroscan. A third EGDs will be performed at 4-year.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
240
Inclusion Criteria
  • Subjects who completed the 2-year RCT study of carvedilol in HBV cirrhotic patients with anti-viral therapy;
  • Subjects who are willing to participate the extension study.
Exclusion Criteria
  • Subjects who refused to receive 2-year EGD examination during the previous RCT study;
  • Subjects who could not compliance with the protocol judged by investigators;
  • Subjects who are not suitable for the study judged by investigators.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Carvedilol+ NUCs therapyCarvedilol 12.5 MGPatients randomized to Carvedilol combined with NUCs group during the previous 2-year treatment of RCT study; Patients showed the progression of esophageal varices in NUCs group during the 2-year treatment of RCT study. Based on nucleoside analogue (NUCs), carvedilol will be added to the patients. Carvedilol is started at a dose of 6.25 mg once per day, and will increase to a dose of 12.5 mg once per day after 1 week. Target dose will be maintained at 12.5 mg once per day if patients with systolic blood pressure not lower than 90 mm Hg and HR no less than 50 beats/min.
Primary Outcome Measures
NameTimeMethod
The progression incidence of esophageal varices after 4-year therapy4-year

Progression of esophageal varices defines as follows:

1. Varices developed from small (F1) to medium or large (F2/F3)

2. Varices developed from medium (F2) to large (F3)

3. New-onset red sign without change in the degree of varices.

4. Bleeding from esophageal varices.

Secondary Outcome Measures
NameTimeMethod
The incidence of liver cirrhosis decompensation4-year

Cumulative rate of liver cirrhosis decompensation, including bleeding, ascites, hepatic encephalopathy, ect.

The incidence of hepatic cellular carcinoma, death or liver transplantation.4-year

Cumulative rate of hepatic cellular carcinoma, death or liver transplantation.

The change of non-invasive assessment score reflecting liver fibrosis.4-year

Higher scores mean a worse outcome.

The change of non-invasive assessment score reflecting liver function.4-year

Higher scores mean a worse outcome.

The dynamic change of liver stiffness quantified by transient elastography.4-year

The dynamic change of liver stiffness quantified by transient elastography.

Trial Locations

Locations (14)

Peking University People's Hospital

🇨🇳

Beijing, Beijing, China

Beijing Friendship Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

Beijing Ditan Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

The First Affiliated Hospital of Shanghai Jiao Tong University

🇨🇳

Shanghai, Shanghai, China

Shanghai Public Health Clinical Center

🇨🇳

Shanghai, Shanghai, China

Beijing Youan Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

Beijing Ditan Hospital Capital Medical University

🇨🇳

Beijing, Beijing, China

Affiliated Hospital of Yanbian University

🇨🇳

Yanji, Jilin, China

Tianjin Second People's Hospital

🇨🇳

Tianjin, Tianjin, China

Tianjin Third Central Hospital, Tianjin Medical University

🇨🇳

Tianjin, Tianjin, China

Tianjin Xiqing Hospital

🇨🇳

Tianjin, Tianjin, China

Zhongshan Hospital Fudan University

🇨🇳

Shanghai, Shanghai, China

Xinjiang Uygur Autonomous Region Traditional Chinese Medicine Hospital

🇨🇳

Xinjiang, Xinjiang, China

Peking University First Hospital

🇨🇳

Beijing, Beijing, China

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