CHESS-SAVE Score to Stratify Decompensation Risk in Compensated Advanced Chronic Liver Disease (CHESS2102)

NCT ID: NCT04975477

Last Updated: 2021-07-23

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

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-07-16

Study Completion Date

2021-08-16

Brief Summary

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Compensated advanced chronic liver disease (cACLD) was associated with a high rate of variceal bleeding, ascites, and hepatic encephalopathy due to portal hypertension. In these patients, esophagogastroduodenoscopy and hepatic venous pressure gradient were recommended methods to evaluate portal hypertension. However, non-invasive predictors of outcomes to stratify care remains needed. Although the updated EASL guideline has recommended that patients with liver stiffness \>20kPa or platelets \<150\*10\^9/L had the high risk of decompensation, the criteria remains to be validated. This international multicenter study aims to develop a novel CHESS-SAVE score to further predict the risk of liver decompensation in cACLD patients.

Detailed Description

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Compensated advanced chronic liver disease (cACLD) was associated with a high rate of variceal bleeding, ascites, and hepatic encephalopathy due to portal hypertension. In these patients, esophagogastroduodenoscopy and hepatic venous pressure gradient were recommended methods to evaluate portal hypertension. However, non-invasive predictors of outcomes to stratify care remains needed. Although the updated EASL guideline has recommended that patients with liver stiffness \>20kPa or platelets \<150\*10\^9/L had the high risk of decompensation, the criteria remains to be validated. This international multicenter study initialed and enrolled by Chinese Portal Hypertension Alliance (CHESS) aims to develop a novel CHESS-SAVE score to further predict the risk of liver decompensation in cACLD patients.

Conditions

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Compensated Advanced Chronic Liver Disease

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Training cohort

A cohort was used to develop the novel score for predicting liver decompensation

Esophagogasrtoduodendoscopy and liver stiffness

Intervention Type PROCEDURE

Time frame between elastography measurement and esophagogastroduodendoscopy is within 6 months.

Validation cohort

A cohort was used to validate the performance of novel score for predicting liver decompensation

Esophagogasrtoduodendoscopy and liver stiffness

Intervention Type PROCEDURE

Time frame between elastography measurement and esophagogastroduodendoscopy is within 6 months.

Exploratory cohort

A cohort was used to study the diagnostic value of novel score for clinically significant portal hypertension

Esophagogasrtoduodendoscopy and liver stiffness

Intervention Type PROCEDURE

Time frame between elastography measurement and esophagogastroduodendoscopy is within 6 months.

hepatic venous pressure gradient

Intervention Type PROCEDURE

A method was used to evaluate portal pressure.

Interventions

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Esophagogasrtoduodendoscopy and liver stiffness

Time frame between elastography measurement and esophagogastroduodendoscopy is within 6 months.

Intervention Type PROCEDURE

hepatic venous pressure gradient

A method was used to evaluate portal pressure.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* age more than 18 years;
* fulfilled diagnosis of cACLD based on radiological, histological features of liver cirrhosis


* age more than 18 years;
* fulfilled diagnosis of cACLD based on radiological, histological features of liver cirrhosis

Exclusion Criteria

* prior liver decompensation;
* hepatocellular carcinoma;
* prior liver transplantation;
* portal vein thrombosis;
* antiplatelet or anticoagulation;
* without screening EGD within six months of TE;
* incomplete follow-up data.

HVPG cohort


* prior liver decompensation;
* hepatocellular carcinoma;
* prior liver transplantation;
* portal vein thrombosis;
* antiplatelet or anticoagulation;
* without screening EGD within six months of TE;
* without HVPG measurement;
* non-sinusoidal portal hypertension.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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LanZhou University

OTHER

Sponsor Role collaborator

Institute of Liver and Biliary Sciences (ILBS)

UNKNOWN

Sponsor Role collaborator

Zagazig University

OTHER_GOV

Sponsor Role collaborator

Korea University

OTHER

Sponsor Role collaborator

Ehime University Graduate School of Medicine

OTHER

Sponsor Role collaborator

Hyogo Medical University

OTHER

Sponsor Role collaborator

Tianjin Second People's Hospital

OTHER

Sponsor Role collaborator

Ruijin Hospital

OTHER

Sponsor Role collaborator

Hepatopancreatobiliary Surgery Institute of Gansu Province

OTHER

Sponsor Role lead

Responsible Party

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Xiaolong Qi

Chief

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ruijin Hospital

Shanghai, , China

Site Status

Tianjin Second People's Hospital

Tianjin, , China

Site Status

Zagazig University Faculty of Medicine

Zagazig, , Egypt

Site Status

Institute of Liver and Biliary Sciences

New Delhi, , India

Site Status

Ehime University Graduate School of Medicine

Matsuyama, , Japan

Site Status

Hyogo College of Medicine

Nishinomiya, , Japan

Site Status

Korea University Ansan Hospital

Gyeonggi-do, , South Korea

Site Status

Countries

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China Egypt India Japan South Korea

Central Contacts

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Xiaolong Qi, MD

Role: CONTACT

+8618588602600 ext. +8618588602600

Chuan Liu, MD

Role: CONTACT

Facility Contacts

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Qing Xie, MD

Role: primary

Jia Li, MD

Role: primary

Shiv Sarin, MD

Role: primary

Hirayuki Enomoto, MD

Role: primary

Hyung Joon Yim, MD

Role: primary

References

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Qi X, Berzigotti A, Cardenas A, Sarin SK. Emerging non-invasive approaches for diagnosis and monitoring of portal hypertension. Lancet Gastroenterol Hepatol. 2018 Oct;3(10):708-719. doi: 10.1016/S2468-1253(18)30232-2.

Reference Type BACKGROUND
PMID: 30215362 (View on PubMed)

de Franchis R; Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015 Sep;63(3):743-52. doi: 10.1016/j.jhep.2015.05.022. Epub 2015 Jun 3. No abstract available.

Reference Type BACKGROUND
PMID: 26047908 (View on PubMed)

Villanueva C, Albillos A, Genesca J, Garcia-Pagan JC, Calleja JL, Aracil C, Banares R, Morillas RM, Poca M, Penas B, Augustin S, Abraldes JG, Alvarado E, Torres F, Bosch J. beta blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2019 Apr 20;393(10181):1597-1608. doi: 10.1016/S0140-6736(18)31875-0. Epub 2019 Mar 22.

Reference Type BACKGROUND
PMID: 30910320 (View on PubMed)

Sarin SK, Lamba GS, Kumar M, Misra A, Murthy NS. Comparison of endoscopic ligation and propranolol for the primary prevention of variceal bleeding. N Engl J Med. 1999 Apr 1;340(13):988-93. doi: 10.1056/NEJM199904013401302.

Reference Type BACKGROUND
PMID: 10099140 (View on PubMed)

Cholongitas E, Papatheodoridis GV, Vangeli M, Terreni N, Patch D, Burroughs AK. Systematic review: The model for end-stage liver disease--should it replace Child-Pugh's classification for assessing prognosis in cirrhosis? Aliment Pharmacol Ther. 2005 Dec;22(11-12):1079-89. doi: 10.1111/j.1365-2036.2005.02691.x.

Reference Type BACKGROUND
PMID: 16305721 (View on PubMed)

Chen RC, Cai YJ, Wu JM, Wang XD, Song M, Wang YQ, Zheng MH, Chen YP, Lin Z, Shi KQ. Usefulness of albumin-bilirubin grade for evaluation of long-term prognosis for hepatitis B-related cirrhosis. J Viral Hepat. 2017 Mar;24(3):238-245. doi: 10.1111/jvh.12638. Epub 2016 Nov 14.

Reference Type BACKGROUND
PMID: 27862671 (View on PubMed)

Abraldes JG, Bureau C, Stefanescu H, Augustin S, Ney M, Blasco H, Procopet B, Bosch J, Genesca J, Berzigotti A; Anticipate Investigators. Noninvasive tools and risk of clinically significant portal hypertension and varices in compensated cirrhosis: The "Anticipate" study. Hepatology. 2016 Dec;64(6):2173-2184. doi: 10.1002/hep.28824. Epub 2016 Oct 27.

Reference Type BACKGROUND
PMID: 27639071 (View on PubMed)

Thabut D, Bureau C, Layese R, Bourcier V, Hammouche M, Cagnot C, Marcellin P, Guyader D, Pol S, Larrey D, De Ledinghen V, Ouzan D, Zoulim F, Roulot D, Tran A, Bronowicki JP, Zarski JP, Goria O, Cales P, Peron JM, Alric L, Bourliere M, Mathurin P, Blanc JF, Abergel A, Serfaty L, Mallat A, Grange JD, Attali P, Bacq Y, Wartelle-Bladou C, Dao T, Pilette C, Silvain C, Christidis C, Capron D, Bernard-Chabert B, Hillaire S, Di Martino V, Sutton A, Audureau E, Roudot-Thoraval F, Nahon P; ANRS CO12 CirVir group. Validation of Baveno VI Criteria for Screening and Surveillance of Esophageal Varices in Patients With Compensated Cirrhosis and a Sustained Response to Antiviral Therapy. Gastroenterology. 2019 Mar;156(4):997-1009.e5. doi: 10.1053/j.gastro.2018.11.053. Epub 2019 Feb 13.

Reference Type BACKGROUND
PMID: 30768988 (View on PubMed)

European Association for the Study of the Liver. EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis - 2021 update. J Hepatol. 2021 Sep;75(3):659-689. doi: 10.1016/j.jhep.2021.05.025. Epub 2021 Jun 21.

Reference Type BACKGROUND
PMID: 34166721 (View on PubMed)

Liu C, Cao Z, Yan H, Wong YJ, Xie Q, Hirooka M, Enomoto H, Kim TH, Hanafy AS, Liu Y, Huang Y, Li X, Kang N, Koizumi Y, Hiasa Y, Nishimura T, Iijima H, Jung YK, Yim HJ, Guo Y, Zhang L, Ma J, Kumar M, Jindal A, Teh KB, Sarin SK, Qi X. A Novel SAVE Score to Stratify Decompensation Risk in Compensated Advanced Chronic Liver Disease (CHESS2102): An International Multicenter Cohort Study. Am J Gastroenterol. 2022 Oct 1;117(10):1605-1613. doi: 10.14309/ajg.0000000000001873. Epub 2022 Jun 15.

Reference Type DERIVED
PMID: 35973168 (View on PubMed)

Other Identifiers

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CHESS2102

Identifier Type: -

Identifier Source: org_study_id

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