Personalized Long-term Human Albumin Treatment in Patients With Decompensated Cirrhosis and Ascites

NCT ID: NCT05056220

Last Updated: 2025-08-05

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

240 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-26

Study Completion Date

2026-09-30

Brief Summary

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The goal of this clinical biomarker validation trial is to test the effect of a predictive biomarker panel to human albumin infusions in patients with liver cirrhosis and ascites. The main questions it aims to answer are:

* If the predictive biomarker panel can identify patients who are likely to benefit from regular human albumin infusions
* If the predictive biomarker panel can lower the number-needed-to-treat of regular human albumin infusions in patients with liver cirrhosis and ascites

The predictive biomarker panel will stratify patients into either a high- or low-expected effect of human albumin infusions. Hereafter are participants randomized into treatment arms.

Participants in the active treatment arm will receive regular human albumin infusions during a course of 6 months. Infusions will occur every 10th day for the duration of the study.

Researchers will compare 20% human albumin infusions with regular 0.9% sodium chloride to identify the effects on the number of liver-related events.

Detailed Description

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Conditions

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Decompensated Cirrhosis and Ascites

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
There will exist two levels of masking in the current trial. Masking of biostratification outcome (high expected effect of human albumin or low expected effect of human albumin): Participant, Investigator and Outcome Assessor Masking of treatment assignment (human albumin 20% or saline 0.9%): Participant and Outcome Assessor

Study Groups

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High expected effect: Human Albumin 20% + Standard Medical Treatment

Participants stratified to a high expected effect of human albumin and randomized to active treatment with 20% Human Albumin infusions.

Group Type ACTIVE_COMPARATOR

Human albumin

Intervention Type DRUG

20% Human Albumin infusions (every 10th day +/- 4 days) with dosing according to the participants bodyweight (1.5 grams of albumin per kg bodyweight with a maximum of 100 grams)

High expected effect: Saline (NaCl 0.9%) + Standard Medical Treatment

Participants stratified to a high expected effect of human albumin and randomized to placebo treatment with 0.9% NaCl (saline) infusions.

Group Type PLACEBO_COMPARATOR

sodium chloride

Intervention Type DRUG

0.9% NaCl infusions (every 10th day +/- 4 days) with dosing according to the corresponding volume used of 20% Human Albumin (1.5 grams of albumin per kg bodyweight with a maximum of 100 grams)

Low expected effect: Human Albumin 20% + Standard Medical Treatment

Participants stratified to a low expected effect of human albumin and randomized to active treatment with 20% Human Albumin infusions.

Group Type ACTIVE_COMPARATOR

Human albumin

Intervention Type DRUG

20% Human Albumin infusions (every 10th day +/- 4 days) with dosing according to the participants bodyweight (1.5 grams of albumin per kg bodyweight with a maximum of 100 grams)

Low expected effect: Saline (NaCl 0.9%) + Standard Medical Treatment

Participants stratified to a low expected effect of human albumin and randomized to placebo treatment with 0.9% NaCl (saline) infusions.

Group Type PLACEBO_COMPARATOR

sodium chloride

Intervention Type DRUG

0.9% NaCl infusions (every 10th day +/- 4 days) with dosing according to the corresponding volume used of 20% Human Albumin (1.5 grams of albumin per kg bodyweight with a maximum of 100 grams)

Interventions

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Human albumin

20% Human Albumin infusions (every 10th day +/- 4 days) with dosing according to the participants bodyweight (1.5 grams of albumin per kg bodyweight with a maximum of 100 grams)

Intervention Type DRUG

sodium chloride

0.9% NaCl infusions (every 10th day +/- 4 days) with dosing according to the corresponding volume used of 20% Human Albumin (1.5 grams of albumin per kg bodyweight with a maximum of 100 grams)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Decompensated liver cirrhosis defined as Child-Pugh score 7-12
* Clinical and/or ultrasound evidenced ascites
* Age ≥ 18 years
* At least five days since resolution of a decompensation event or any condition requiring hospitalisation

Exclusion Criteria

* Patients with acute or subacute liver failure without underlying cirrhosis
* Patients with cirrhosis who develop decompensation in the postoperative period following partial hepatectomy
* Refractory ascites as defined by the International Ascites Club
* Existing TIPS
* Portal vein thrombosis
* Severe alcoholic hepatitis (Glasgow Alcoholic Hepatitis Score \> 11)
* Hepatic encephalopathy grade III-IV
* Current, planned or previous treatment with direct antiviral agents for hepatitis C virus (HCV) in the last six months Contraindications for human albumin infusion (pulmonary oedema, hypersensitivity etc.)
* Evidence of current malignancy except for non-melanocytic skin cancer and hepatocellular carcinoma within Barcelona Clinic Liver Cancer (BCLC)-0 or BCLC-A
* Presence or history of severe extra-hepatic diseases (e.g.,chronic renal failure requiring hemodialysis, severe heart disease (NYHA \> II); severe chronic pulmonary disease (GOLD Score ≥ C), severe neurological and psychiatric disorders, pulmonary arterial hypertension)
* HIV positive or other condition associated with and/or requiring immunosuppression
* Previous liver or other transplantation
* Pregnancy
* Breastfeeding
* Patients who decline to participate, patients who cannot provide prior written informed consent due to other causes than hepatic encephalopathy or patients with hepatic encephalopathy who cannot provide prior written informed consent and when there is documented evidence that the patient has no legal surrogate decision maker or sufficient ability to provide delayed informed consent
* Physician's denial (investigator considers that the patient will not adhere to the study protocol scheduled, e.g. in case of heavy drinking)
* Participation in another study within 3 months prior to screening
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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EASL - CLIF Consortium

OTHER

Sponsor Role collaborator

Aleksander Krag

OTHER

Sponsor Role lead

Responsible Party

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Aleksander Krag

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Aleksander Krag, Professor

Role: PRINCIPAL_INVESTIGATOR

Odense University Hospital

Locations

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Katholieke Universiteit Leuven

Leuven, , Belgium

Site Status RECRUITING

Herlev Hospital

Herlev, , Denmark

Site Status RECRUITING

Odense University Hospital

Odense, , Denmark

Site Status RECRUITING

Charité - Universitätsmedizin Berlin

Berlin, , Germany

Site Status ACTIVE_NOT_RECRUITING

Universitätsklinikum Jena

Jena, , Germany

Site Status NOT_YET_RECRUITING

Universitätsklinikum Münster

Münster, , Germany

Site Status RECRUITING

Debreceni Egyetem

Debrecen, , Hungary

Site Status RECRUITING

Academisch Ziekenhuis Leiden

Leiden, , Netherlands

Site Status RECRUITING

Alrijne Ziekenhuis Leiden

Leiderdorp, , Netherlands

Site Status RECRUITING

Hospital Clinic Barcelona

Barcelona, , Spain

Site Status RECRUITING

Hospital Del Mar

Barcelona, , Spain

Site Status RECRUITING

King's College Hospital

London, , United Kingdom

Site Status NOT_YET_RECRUITING

Countries

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Belgium Denmark Germany Hungary Netherlands Spain United Kingdom

Central Contacts

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Aleksander Krag, Professor

Role: CONTACT

+4566113333

Jonel Trebicka, Professor

Role: CONTACT

Facility Contacts

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Wim Laleman

Role: primary

Mette Lehmann Andersen

Role: primary

Nikolaj Torp

Role: primary

Alexander Zipprich

Role: primary

Jonel Trebicka

Role: primary

Maria Papp

Role: primary

Minneke Coenraad

Role: primary

Sunje Abraham

Role: primary

Pere Ginés

Role: primary

Montserrat Garcia Retortillo

Role: primary

Debbie Shawcross

Role: primary

References

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Torp N, Israelsen M, Coenraad M, Papp M, Shawcross D, Korenjak M, Angeli P, Laleman W, Juanola A, Gines P, Trebicka J, Krag A; MICROB-PREDICT Consortium. Personalised human albumin in patients with cirrhosis and ascites: design and rationale for the ALB-TRIAL - a randomised clinical biomarker validation trial. BMJ Open. 2024 Feb 14;14(2):e079309. doi: 10.1136/bmjopen-2023-079309.

Reference Type DERIVED
PMID: 38355195 (View on PubMed)

Other Identifiers

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825694

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2022-501006-34-01

Identifier Type: -

Identifier Source: org_study_id

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