The Effects of Nitazoxanide in Hepatic Encephalopathy

NCT ID: NCT02334163

Last Updated: 2015-01-08

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

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-12-31

Study Completion Date

2015-04-30

Brief Summary

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Evaluating the efficacy and safety of nitazoxanide in comparison to standard treatment in patients with grade II-III hepatic encephalopathy (HE). Also, Evaluating the effect of administering nitazoxanide on the improvement of patient's quality of life.

Detailed Description

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Nitazoxanide (NTZ) is a thiazolide anti-infective with activity against anaerobic bacteria, protozoa and viruses. A pilot prospective study at the 2008 American Association for the Study of Liver Diseases meeting showing clinical improvement in HE among cirrhotic patients who received nitazoxanide and lactulose. Based on the excellent safety profile of NTZ, the present pilot study is conducted hopefully to prove the efficacy of nitazoxanide in treating patients experiencing HE grade II-III.

Study design:The study is Prospective, Randomized, Controlled, Open-Label, Pilot study.

Method: The study will include a total of 36 patients with grade II-III Hepatic Encephalopathy, and an informed consent will be obtained from every patient before being included.

All the patients will receive oral lactulose, plus either nitazoxanide, metronidazole or rifaximine.

A- All patients will be subjected to the following at baseline:

* Patient's full history
* Liver disease staging using Model for End stage Liver Disease (MELD) score
* Measurement of serum electrolytes (Na+, K+, Ca2+)

B- All patients will be subjected to the following at baseline and at the end of treatment:

* Measuring Blood ammonia level
* Measuring liver function tests (AST, Total bilirubin, international normalized ratio (INR), Serum albumin, prothrombin time (PT)), serum creatinine and complete blood count (CBC)
* Assessing severity of Hepatic Encephalopathy using Clinical Hepatic Encephalopathy Staging Scale (CHESS)

C- Monitoring tolerability up to 30 days after the last dose D- Assessment of quality of life using Chronic Liver Disease Questionnaire (CLDQ)

Conditions

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Hepatic Encephalopathy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Nitazoxanide group

12 patients will receive the following for 7 days:

* Oral lactulose
* 500 mg nitazoxanide tablets twice daily

Group Type EXPERIMENTAL

Nitazoxanide

Intervention Type DRUG

500 mg nitazoxanide tablets twice daily

Oral lactulose

Intervention Type DRUG

Oral lactulose (65%)

Metronidazole group

12 patients will receive the following for 7 days:

* Oral lactulose
* 250 mg metronidazole tablets every 8 hours

Group Type ACTIVE_COMPARATOR

Oral lactulose

Intervention Type DRUG

Oral lactulose (65%)

Metronidazole

Intervention Type DRUG

250 mg metronidazole tablets every 8 hours

Rifaximine group

12 patients will receive the following for 7 days:

* Oral lactulose
* Two 200 mg rifaximine tablets every 8 hours

Group Type ACTIVE_COMPARATOR

Oral lactulose

Intervention Type DRUG

Oral lactulose (65%)

Rifaximine

Intervention Type DRUG

Two 200 mg rifaximine tablets every 8 hours

Interventions

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Nitazoxanide

500 mg nitazoxanide tablets twice daily

Intervention Type DRUG

Oral lactulose

Oral lactulose (65%)

Intervention Type DRUG

Metronidazole

250 mg metronidazole tablets every 8 hours

Intervention Type DRUG

Rifaximine

Two 200 mg rifaximine tablets every 8 hours

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Adult Patients from 18 to 65 years.
* Patients with grade II-III Hepatic Encephalopathy.

Exclusion Criteria

* Patients with active GIT bleeding.
* Patients with major psychiatric illness.
* Patients receiving benzodiazepines, narcotics, alcohol and marijuana.
* Patients with compromised renal or biliary functions.
* Patients known to have AIDS.
* Patients receiving medications highly bound to plasma proteins eg. Warfarin.
* Patients with known hypersensitivity to nitazoxanide.
* Pregnant or lactating women.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Al-Azhar University

OTHER

Sponsor Role collaborator

Ain Shams University

OTHER

Sponsor Role lead

Responsible Party

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Asmaa Abdel Aziz ElRakaybi

Teaching assistant

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Asmaa A. Elrakaybi, Bachelor

Role: PRINCIPAL_INVESTIGATOR

Ain Shams University

Locations

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Faculty of medicine, Ain Shams University

Cairo, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Amal T. Abd ElMoez, PhD

Role: CONTACT

Facility Contacts

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Amal T. Abd ElMoez, PhD

Role: primary

Other Identifiers

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PHCL400

Identifier Type: -

Identifier Source: org_study_id

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