Human Albumin Infusion in Liver Cirrhosis and Overt Hepatic Encephalopathy (HACHE)

NCT ID: NCT06483737

Last Updated: 2025-08-26

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

NA

Total Enrollment

174 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-24

Study Completion Date

2027-06-30

Brief Summary

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Hepatic encephalopathy (HE), a severe complication of decompensated cirrhosis, is characterized as neurocognitive dysfunction. Emerging evidence suggests the potential role of human albumin infusion for the treatment of HE, but its optimal dosage remains undefined. Therefore, the investigators planned a randomized controlled trial (RCT) to compare the efficacy of human albumin infusion at different dosages in in patients with liver cirrhosis and overt HE.

Detailed Description

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Overall, 174 patients with a diagnosis of liver cirrhosis, overt HE, and a serum albumin level of 23-30g/L will be enrolled. They will be stratified according to the severity of overt HE and randomly assigned at a ratio of 1:1 into the groups of human albumin infusion at a modified dosage and a routine dosage. The primary endpoint is the improvement of overt HE within 3-5 days after treatment. The secondary endpoints include recurrence of overt HE, survival, and adverse events.

Conditions

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Overt 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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Modified dosage group

Intravenous infusion of human albumin 30-60g.

Group Type EXPERIMENTAL

Human albumin infusion at a modified dosage

Intervention Type DRUG

Participants receive intravenous infusion of human albumin at different dosages according to the serum albumin level.

Lactulose

Intervention Type DRUG

All participants will receive standard treatment of overt HE according to the current practice guideline.

Rifaximin

Intervention Type DRUG

All participants will receive standard treatment of overt HE according to the current practice guideline.

Ornithine Aspartate

Intervention Type DRUG

All participants will receive standard treatment of overt HE according to the current practice guideline.

Branched-Chain Amino Acids

Intervention Type DRUG

All participants will receive standard treatment of overt HE according to the current practice guideline.

Arginine

Intervention Type DRUG

All participants will receive standard treatment of overt HE according to the current practice guideline.

Routine dosage group

Intravenous infusion of human albumin 10-20g.

Group Type ACTIVE_COMPARATOR

Human albumin infusion at a routine dosage

Intervention Type DRUG

Participants receive intravenous infusion of human albumin according to the current clinical practice.

Lactulose

Intervention Type DRUG

All participants will receive standard treatment of overt HE according to the current practice guideline.

Rifaximin

Intervention Type DRUG

All participants will receive standard treatment of overt HE according to the current practice guideline.

Ornithine Aspartate

Intervention Type DRUG

All participants will receive standard treatment of overt HE according to the current practice guideline.

Branched-Chain Amino Acids

Intervention Type DRUG

All participants will receive standard treatment of overt HE according to the current practice guideline.

Arginine

Intervention Type DRUG

All participants will receive standard treatment of overt HE according to the current practice guideline.

Interventions

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Human albumin infusion at a modified dosage

Participants receive intravenous infusion of human albumin at different dosages according to the serum albumin level.

Intervention Type DRUG

Human albumin infusion at a routine dosage

Participants receive intravenous infusion of human albumin according to the current clinical practice.

Intervention Type DRUG

Lactulose

All participants will receive standard treatment of overt HE according to the current practice guideline.

Intervention Type DRUG

Rifaximin

All participants will receive standard treatment of overt HE according to the current practice guideline.

Intervention Type DRUG

Ornithine Aspartate

All participants will receive standard treatment of overt HE according to the current practice guideline.

Intervention Type DRUG

Branched-Chain Amino Acids

All participants will receive standard treatment of overt HE according to the current practice guideline.

Intervention Type DRUG

Arginine

All participants will receive standard treatment of overt HE according to the current practice guideline.

Intervention Type DRUG

Other Intervention Names

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AlbuRx AlbuRx Duphalac Xifaxan Compound amino acid injection Arginine Hydrochloride Injection

Eligibility Criteria

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Inclusion Criteria

* A definite diagnosis of liver cirrhosis and overt HE
* A serum albumin level of 23-30g/L
* Age ≥18 years old
* Sign the informed consent

Exclusion Criteria

* Contraindications to human albumin infusion
* A history of transjugular intrahepatic portosystemic shunt
* A diagnosis of acute liver failure
* Severe heart and/or lung diseases
* Psychiatric or nervous diseases
* Pregnant or lactating
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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General Hospital of Shenyang Military Region

OTHER

Sponsor Role lead

Responsible Party

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Xingshun Qi

Director of Department of Gastroenterology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xingshun Qi

Role: PRINCIPAL_INVESTIGATOR

Department of Gastroenterology, General Hospital of Northern Theater Command

Locations

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Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area)

Shenyang, Liaoning, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xingshun Qi

Role: CONTACT

18909881019

Qianqian Li

Role: CONTACT

13940307473

Facility Contacts

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Xingshun Qi

Role: primary

18909881019

Qianqian Li

Role: backup

13940307473

References

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Sharma BC, Singh J, Srivastava S, Sangam A, Mantri AK, Trehanpati N, Sarin SK. Randomized controlled trial comparing lactulose plus albumin versus lactulose alone for treatment of hepatic encephalopathy. J Gastroenterol Hepatol. 2017 Jun;32(6):1234-1239. doi: 10.1111/jgh.13666.

Reference Type BACKGROUND
PMID: 27885712 (View on PubMed)

Simon-Talero M, Garcia-Martinez R, Torrens M, Augustin S, Gomez S, Pereira G, Guevara M, Gines P, Soriano G, Roman E, Sanchez-Delgado J, Ferrer R, Nieto JC, Sunye P, Fuentes I, Esteban R, Cordoba J. Effects of intravenous albumin in patients with cirrhosis and episodic hepatic encephalopathy: a randomized double-blind study. J Hepatol. 2013 Dec;59(6):1184-92. doi: 10.1016/j.jhep.2013.07.020. Epub 2013 Jul 19.

Reference Type BACKGROUND
PMID: 23872605 (View on PubMed)

China L, Freemantle N, Forrest E, Kallis Y, Ryder SD, Wright G, Portal AJ, Becares Salles N, Gilroy DW, O'Brien A; ATTIRE Trial Investigators. A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis. N Engl J Med. 2021 Mar 4;384(9):808-817. doi: 10.1056/NEJMoa2022166.

Reference Type BACKGROUND
PMID: 33657293 (View on PubMed)

Bai Z, Bernardi M, Yoshida EM, Li H, Guo X, Mendez-Sanchez N, Li Y, Wang R, Deng J, Qi X. Albumin infusion may decrease the incidence and severity of overt hepatic encephalopathy in liver cirrhosis. Aging (Albany NY). 2019 Oct 8;11(19):8502-8525. doi: 10.18632/aging.102335. Epub 2019 Oct 8.

Reference Type BACKGROUND
PMID: 31596729 (View on PubMed)

Bai Z, Mendez-Sanchez N, Romeiro FG, Mancuso A, Philips CA, Tacke F, Basaranoglu M, Primignani M, Ibrahim M, Wong YJ, Nery FG, Teschke R, Ferreira CN, Munoz AE, Pinyopornpanish K, Thevenot T, Singh SP, Mohanty A, Satapathy SK, Ridola L, Maruyama H, Cholongitas E, Levi Sandri GB, Yang L, Shalimar, Yang Y, Villa E, Krag A, Wong F, Jalan R, O'Brien A, Bernardi M, Qi X; Liver Cirrhosis-related Complications (LCC)-International Special Interest Group. Use of albumin infusion for cirrhosis-related complications: An international position statement. JHEP Rep. 2023 May 5;5(8):100785. doi: 10.1016/j.jhepr.2023.100785. eCollection 2023 Aug.

Reference Type BACKGROUND
PMID: 37456673 (View on PubMed)

Other Identifiers

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XHNKKY-OHE-RCT

Identifier Type: -

Identifier Source: org_study_id

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