Use of Sanvar® With Endoscopic Treatment for the Control of Acute Variceal Bleeding

NCT ID: NCT00331188

Last Updated: 2008-07-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-05-31

Study Completion Date

2008-07-31

Brief Summary

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The main objective of this study is to determine the efficacy of early administration of Sanvar® in combination with endoscopic treatment for the control of acute variceal bleeding.

Detailed Description

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This is a single-arm open-label clinical study with historical controls using Sanvar® (vapreotide) administered for 5 days in patients with acute variceal bleeding due to portal hypertension.

Cirrhotic patients with a history of acute hematemesis and/or melena admitted to the emergency unit and meeting the eligibility criteria will receive, as soon as possible after admission (within a maximum of 24 hours after onset of hemorrhage and within 6 hours after admission), Sanvar® (vapreotide acetate) 50 µg IV bolus followed by an IV continuous infusion of 50 µg/h for 5 days.

The diagnostic and therapeutic endoscopy will be performed as soon as possible after the initiation of the study drug infusion, but no more than 12 hours after the patient's admission to the study center. A final follow up will be performed on Day 42.

Patients for whom the source of bleeding is determined at endoscopy to be due to a cause other than portal hypertension (e.g. gastric ulcer) will be replaced. In addition, in such cases the study medication will be discontinued and patients will receive standard treatment according to the cause of their bleeding. These patients will be followed up for safety only.

\*Note: There is no provision in this study to have an expanded access program.

Conditions

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Esophageal Varices Portal Hypertension Gastric Varices Esophageal Bleeding

Keywords

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Esophageal Variceal Bleeding Portal Hypertension Hepatic Cirrhosis Cirrhosis Liver Cirrhosis Somatostatin Analog Vapreotide Acute Esophageal Variceal Bleeding

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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Sanvar® (vapreotide)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Female or male cirrhotic patient aged 18 to 75 years.
* Hematemesis and/or melena (suspected to be caused by portal hypertension)
* Time interval \<=24 hours between onset of initial hemorrhage and initiation of study drug infusion.
* Time interval \<=6 hours between admission and initiation of study drug infusion.
* Anticipated time interval\<=12 hours between admission and end of therapeutic endoscopy.
* Unequivocal history of cirrhosis, either documented by at least one of classical clinical signs (abdominal collateral venous circulation, firm liver with a sharp lower liver edge, presence of spider naevi, and/or ascites), or by biochemical and/or Doppler-US signs.
* Written informed consent obtained by the patient or his/her relative(s)

Exclusion Criteria

* Patient previously included in this study for a prior bleeding episode.
* Patients treated with a vasoactive drug such as octreotide, vasopressin or its analogue for the current episode of bleeding.
* Hepatic encephalopathy Grade IV.
* Balloon tamponade already positioned at admission.
* Known Child-Pugh score \>=13
* Pregnant or breast-feeding women.
* Known diffuse hepatocellular carcinoma.
* Known complete portal venous thrombosis.
* Bleeding from esophageal varices within the previous 6 weeks.
* Patient currently enrolled in another therapeutic study, and/or who participated in another clinical study, within the previous 6 weeks.
* Known allergy to somatostatin or somatostatin analogues.
* Previous porto-systemic shunt (TIPS) or orthotopic liver transplantation.
* Patient with known cancer.
* Patient with known chronic renal failure (serum creatinine \> 1.5 mg/dl).
* Severe concomitant disease judged by the Investigator as being incompatible with evaluation of treatment.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Debiovision

INDUSTRY

Sponsor Role lead

Responsible Party

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Debiovision

Principal Investigators

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Joseph Lim, M.D.

Role: STUDY_CHAIR

Yale University

Tarek Hassanein, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of California, San Diego

Michael B. Fallon, M.D.

Role: PRINCIPAL_INVESTIGATOR

UAB Liver Center, Division of Gastroenterology & Hepatology

Daniel R. Ganger, M.D.

Role: PRINCIPAL_INVESTIGATOR

Northwestern Memorial Hospital

Naga P. Chalasani, M.D.

Role: PRINCIPAL_INVESTIGATOR

Indiana University School of Medicine

Adrian Reuben, M.D.

Role: PRINCIPAL_INVESTIGATOR

Medical University of South Carolina

Paul J. Thuluvath, M.D.

Role: PRINCIPAL_INVESTIGATOR

The Johns Hopkins Hospital & School of Medicine

James F. Trotter, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Colorado, Denver

Hugo Vargas, M.D.

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic Scottsdale, Arizona

Samuel Sigal, M.D.

Role: PRINCIPAL_INVESTIGATOR

Weill Medical College of Cornell University

Michele D. Bishop, M.D.

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic Jacksonville Florida

Gary A. Abrams, M.D.

Role: PRINCIPAL_INVESTIGATOR

Alabama Liver & Digestive Specialists Research Center - Montgomery, AB

Robert S. McFadden, M.D.

Role: PRINCIPAL_INVESTIGATOR

CHRISTUS Santa Rosa Medical Center - San Antonio, TX

Nezam H. Afdhal, M.D.

Role: PRINCIPAL_INVESTIGATOR

Beth Israel Deaconess Medical Center, Boston MA

Jeffrey S. Crippin, M.D.

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Alvaro Koch, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Kentucky Medical Center - Lexington, KY

Kimberly Beavers, M.D., M. Ph.

Role: PRINCIPAL_INVESTIGATOR

Mission Hospitals, Inc. - Asheville, NC

Arun J. Sanyal, M.D.

Role: PRINCIPAL_INVESTIGATOR

Virginia Commonwealth University

Locations

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UAB Liver Center

Birmingham, Alabama, United States

Site Status

Alabama Liver & Digestive Specialists

Montgomery, Alabama, United States

Site Status

Mayo Clinic

Scottsdale, Arizona, United States

Site Status

University of California at San Diego

San Diego, California, United States

Site Status

University of Colorado Health Sciences Center

Denver, Colorado, United States

Site Status

Yale University School of Medicine

New Haven, Connecticut, United States

Site Status

Mayo Clinic

Jacksonville, Florida, United States

Site Status

Northwestern University, The Feinberg School of Medicine

Chicago, Illinois, United States

Site Status

Indiana University School of Medicine

Indianapolis, Indiana, United States

Site Status

University of Kentucky Medical Center

Lexington, Kentucky, United States

Site Status

Johns Hopkins Hospital & School of Medicine, Div. of Gastroenterology & Hepatology

Baltimore, Maryland, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Weill Medical College of Cornell University

New York, New York, United States

Site Status

Columbia University Medical Center

New York, New York, United States

Site Status

Mission Hospitals, Inc.

Asheville, North Carolina, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

CHRISTUS Santa Rosa Medical Center

San Antonio, Texas, United States

Site Status

Virginia Commonwealth University MCV Campus West Hospital

Richmond, Virginia, United States

Site Status

Countries

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United States

References

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Cales P, Masliah C, Bernard B, Garnier PP, Silvain C, Szostak-Talbodec N, Bronowicki JP, Ribard D, Botta-Fridlund D, Hillon P, Besseghir K, Lebrec D; French Club for the Study of Portal Hypertension. Early administration of vapreotide for variceal bleeding in patients with cirrhosis. N Engl J Med. 2001 Jan 4;344(1):23-8. doi: 10.1056/NEJM200101043440104.

Reference Type BACKGROUND
PMID: 11136956 (View on PubMed)

Related Links

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Other Identifiers

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DEBV-VAP/EVB-301

Identifier Type: -

Identifier Source: org_study_id