Role of Nutritional Intervention for the Treatment of Sarcopenia in Cirrhotic Patients with Refractory Ascites Candidate to Transjugular Intrahepatic Portosystemic Shunt Placement and Identification of Prognostic Factors Related to Clinical Outcome

NCT ID: NCT06814626

Last Updated: 2025-02-11

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

72 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-10-13

Study Completion Date

2025-12-31

Brief Summary

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The hypothesis is that in patients with cirrhosis and refractory ascites candidate to TIPS, and sarcopenia (identified by a PMA ≤16 cm² at the level of L3), who are at high-risk of 6-month mortality after TIPS placement, a post-TIPS 12 weeks nutritional intervention is associated with improved post-TIPS prognosis.

The primary objective is to evaluate the effect of a post-TIPS 12 weeks nutritional intervention on liver transplant-free six-month survival in sarcopenic candidates to TIPS for refractory ascites in cirrhosis.

Detailed Description

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Conditions

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Liver Cirrhosis Refractory Ascites in Patients with Cirrhosis Sarcopenia in Liver Cirrhosis

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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12 weeks post-TIPS nutritional dietary intervention

Group Type EXPERIMENTAL

12-week nutritional intervention with Friliver dispensing

Intervention Type DIETARY_SUPPLEMENT

After TIPS placement patients of the treatment group receive a 12-week nutritional intervention that includes a personalized diet, Friliver dispensing (Dompé; 2 sachets 3 times a day) and a diet diary to report the quantity and quality of the foods eaten every single day.

12-week nutritional intervention with personalized diet

Intervention Type OTHER

After TIPS placement patients of the treatment group receive a 12-week nutritional intervention that includes a personalized diet, Friliver dispensing (Dompé; 2 sachets 3 times a day) and a diet diary to report the quantity and quality of the foods eaten every single day.

12-week nutritional intervention with diet diary to report foods eaten.

Intervention Type OTHER

After TIPS placement patients of the treatment group receive a 12-week nutritional intervention that includes a personalized diet, Friliver dispensing (Dompé; 2 sachets 3 times a day) and a diet diary to report the quantity and quality of the foods eaten every single day.

Standard clinical practice: follow-up post-TIPS placement.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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12-week nutritional intervention with Friliver dispensing

After TIPS placement patients of the treatment group receive a 12-week nutritional intervention that includes a personalized diet, Friliver dispensing (Dompé; 2 sachets 3 times a day) and a diet diary to report the quantity and quality of the foods eaten every single day.

Intervention Type DIETARY_SUPPLEMENT

12-week nutritional intervention with personalized diet

After TIPS placement patients of the treatment group receive a 12-week nutritional intervention that includes a personalized diet, Friliver dispensing (Dompé; 2 sachets 3 times a day) and a diet diary to report the quantity and quality of the foods eaten every single day.

Intervention Type OTHER

12-week nutritional intervention with diet diary to report foods eaten.

After TIPS placement patients of the treatment group receive a 12-week nutritional intervention that includes a personalized diet, Friliver dispensing (Dompé; 2 sachets 3 times a day) and a diet diary to report the quantity and quality of the foods eaten every single day.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* men and women with an age ≥ 18 and ≤ 80 years
* clinical, radiological or histological diagnosis of liver cirrhosis
* diagnosis of RA
* confirmation of sarcopenia defined in CT scan as the sum of the psoas muscle areas measured at the level of the 3rd lumbar vertebra (PMA) ≤16 cm2
* informed consent signed

Exclusion Criteria

* severe hepatic insufficiency (bilirubin\> 5 mg/dl, MELD score\> 18, Child-Pugh score\> 9)
* Congestive heart failure class ≥2 according to New York Heart Association criteria (NYHA)
* Active coronary heart disease (myocardial infarction within 6 months of the study)
* Severe pulmonary hypertension suspected on echocardiogram (systolic pulmonary arterial pressure \[PAPs\]\> 35 mmHg) and confirmed with right cardiac catheterization (PAPs\> 45mmHg)
* Chronic renal failure (creatinine\> 3 mg/dl)
* Performance status ≥2 according to the Eastern Cooperative Oncology Group scale (ECOG)
* History of grade III-IV hepatic encephalopathy or West Haven grade I-II hepatic encephalopathy episodes within the last 3 months
* Uncontrolled systemic sepsis
* Presence of Hepatocellular carcinoma
* Complete portal vein thrombosis
* Active bleeding from gastroesophageal varices. Patients with adequately treated gastroesophageal varices can be included in the study (banding ligation, sclerotherapy)
* Diagnosis of extra hepatic neoplasia
* Transplant recipients
* Patients unable or unwilling to comply with the protocol requirements
* Pregnant or lactating women
* Patients unable to autonomously express their consent (incapable patients)
* any other laboratory condition or result that in the opinion of the Principal Investigator, preclude the subject's participation in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Mediterranean Institute for Transplantation and Advanced Specialized Therapies

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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IRCCS ISMETT - Istituto Mediterraneo per i Trapianti e le Terapie ad Alta Specializzazione

Palermo, , Italy

Site Status RECRUITING

University Clinic for Visceral Surgery and Medicine, Inselspital

Bern, , Switzerland

Site Status RECRUITING

Countries

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Italy Switzerland

Central Contacts

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Angelo Luca, Radiologist

Role: CONTACT

+39 0912192468

Monica Rizzo, Study Coordinator

Role: CONTACT

+39 0912192692

Facility Contacts

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Monica Rizzo, Study Coordinator

Role: primary

+39 091 2192 692

Annalisa Berzigotti

Role: primary

+41 31 632 33 91

Other Identifiers

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IRRB/31/20

Identifier Type: -

Identifier Source: org_study_id

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