A Trial of Somatostatin With Endoscopic Variceal Ligation (EVL) in Control of Acute Variceal Bleeding

NCT ID: NCT01267669

Last Updated: 2010-12-28

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

NA

Total Enrollment

61 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-11-30

Study Completion Date

2009-11-30

Brief Summary

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Background: Efficacy of endoscopic variceal sclerotherapy in achieving initial control of acute variceal bleeding and five-day haemostasis has been shown to significantly improve when vasoactive drug is added. However, there is limited data whether addition of somatostatin, to endoscopic variceal ligation (EVL) improves the efficacy of EVL.

Aim: To compare EVL plus somatostatin versus EVL plus placebo in control of acute variceal bleeding.

Patients and methods: Consecutive cirrhotic patients with acute variceal bleeding from esophageal varices were enrolled in the trial. After emergency EVL, patients were randomized to receive either somatostatin (250 mcg/hr) or placebo infusion. Primary endpoint was treatment failure within 5 days. Treatment failure was defined as fresh hematemesis ≥2 hour after start of therapy or death.

Detailed Description

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Conditions

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Acute Bleeding Esophageal Varices Portal Hypertension Cirrhosis

Keywords

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Variceal bleeding Endoscopic therapy Band ligation Somatostatin Vasoactive drugs Octreotide

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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EVL plus Somatostatin

Emergency EVL plus Somatostatin (250 mcg/hr) infusion for 5 days

Group Type EXPERIMENTAL

Somatostatin

Intervention Type DRUG

Emergency EVL plus Somatostatin (250 mcg/hr) infusion for 5 days

EVL plus Placebo

Emergency EVL plus placebo infusion for 5 days

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Emergency EVL plus placebo infusion for 5 days

Interventions

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Somatostatin

Emergency EVL plus Somatostatin (250 mcg/hr) infusion for 5 days

Intervention Type DRUG

Placebo

Emergency EVL plus placebo infusion for 5 days

Intervention Type DRUG

Other Intervention Names

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Somatosan Somastin

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of portal hypertension
* Having hematemesis and/or melena within 24 hour prior to admission
* Source of bleeding should be esophageal varices

Exclusion Criteria

* Non-cirrhotic cause of portal hypertension
* Age \<12 or \>75 years
* Hepatic encephalopathy grade 3 or 4
* Renal failure with serum creatinine \>2 mg/dL
* Any evidence of bleeding from additional source apart from esophageal varices (like gastric varices, portal hypertensive gastropathy, erosions or ulcers including variceal ulcers)
* Patients already on vasoactive drugs like somatostatin or terlipressin during the current episode of bleeding
* Patients already received EVL or EST elsewhere during the current episode of bleeding prior to presenting to our hospital
* Patients with history of surgery for portal hypertension or TIPS
* Concomitant severe cardio-pulmonary disease
* Concomitant malignancy
* HVPG not possible within 24 hrs of presentation
* Patients refusing to participate in the study.
Minimum Eligible Age

12 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Govind Ballabh Pant Hospital

OTHER_GOV

Sponsor Role lead

Responsible Party

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Department of Gastroenterology, G B Pant Hospital, New Delhi, India

Principal Investigators

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Shiv K Sarin, MD, DM

Role: PRINCIPAL_INVESTIGATOR

G B Pant Hospital

Locations

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Department of Gastroenterology, G B Pant Hospital

New Delhi, National Capital Territory of Delhi, India

Site Status

Countries

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India

References

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Kumar A, Jha SK, Mittal VV, Sharma P, Sharma BC, Sarin SK. Addition of Somatostatin After Successful Endoscopic Variceal Ligation Does not Prevent Early Rebleeding in Comparison to Placebo: A Double Blind Randomized Controlled Trial. J Clin Exp Hepatol. 2015 Sep;5(3):204-12. doi: 10.1016/j.jceh.2015.06.001. Epub 2015 Jun 16.

Reference Type DERIVED
PMID: 26628838 (View on PubMed)

Other Identifiers

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2005-PHT-01

Identifier Type: -

Identifier Source: org_study_id