Effect of Single vs Repeated Cycles of a Combination of Granulocyte Colony Stimulating Factor and Darbepoetin vs Standard Medical Treatment on Immunometabolic Profile in Patient With Early Decompensated Cirrhosis.

NCT ID: NCT07002827

Last Updated: 2025-06-04

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-30

Study Completion Date

2026-04-30

Brief Summary

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Exogenous growth factor-mobilized bone marrow (BM) stem cells(G-CSF) and DARBEPOETIN use have shown a differential response in the management of decompensated cirrhosis (DC) with improved survival, CTP and MELD scores. This study was designed to evaluate potential clinical benefit of repeated cycles of granulocyte-colony stimulating factor (G-CSF) and DARBEPOETIN versus single cycle on delta change in immunometabolic profile of patients at 6 months assessed in terms of -Change in innate immunity -Monocyte, neutrophils -distribution , function and bioenergetic adaptation .

Detailed Description

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Aim: To study the efficacy of single vs repeated cycle of Granulocyte Colony Stimulating Factor+ darbopoetin vs standard medical treatmenton immunometabolic profile in patient with early decompensated cirrhosis

Study population:

* Age 18-70 years
* Early decompensated cirrhosis MELD \< 16 , CTP \< 9B
* Uncomplicated ascites
* A Prospective Randomized Controlled Trial.
* Single Centre.
* Open label.
* Block Randomization will be done , it will be implemented by IWRS method.
* The study will be conducted in Department of Hepatology, ILBS.

Conditions

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Decompensated 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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Standard Medical treatment

Standard medical therapy including lactulose, bowel enema and albumin will be continued in both groups.

Group Type ACTIVE_COMPARATOR

Lactulose

Intervention Type DRUG

Standard Medical Tretament part

Albumin

Intervention Type BIOLOGICAL

Standard Medical Tretament part

Single cycle of G-CSF + darbepoetin and standard medical treatment

* G-CSF will be given at a dose of 5 µg/kg s/c at days 1, 2, 3, 4, 5 and then every third and 7th day till day 30.
* Darbepoetin will be given s/c at dose of 40 mcg once a week (total 4 doses) for 1 month.
* Standard medical therapy including lactulose, bowel enema and albumin will be continued in both groups.

Group Type EXPERIMENTAL

Darbepoetin

Intervention Type DRUG

Darbepoetin will be given s/c at dose of 40 mcg once a week (total 4 doses) for 1 month

G-CSF

Intervention Type DRUG

G-CSF will be given at a dose of 5 µg/kg s/c at days 1, 2, 3, 4, 5 and then every third and 7th day till day 30

Lactulose

Intervention Type DRUG

Standard Medical Tretament part

Albumin

Intervention Type BIOLOGICAL

Standard Medical Tretament part

Three cycles of G-CSF + darbepoetin and standard medical treatment (1-month, 3-month, and 5-month)

* G-CSF will be given at a dose of 5 µg/kg s/c at days 1, 2, 3, 4, 5 and then every third and 7th day till day 30.
* Darbepoetin will be given s/c at dose of 40 mcg once a week (total 4 doses) for 1 month.
* Standard medical therapy including lactulose, bowel enema and albumin will be continued in both groups.

Group Type EXPERIMENTAL

Darbepoetin

Intervention Type DRUG

Darbepoetin will be given s/c at dose of 40 mcg once a week (total 4 doses) for 1 month

G-CSF

Intervention Type DRUG

G-CSF will be given at a dose of 5 µg/kg s/c at days 1, 2, 3, 4, 5 and then every third and 7th day till day 30

Lactulose

Intervention Type DRUG

Standard Medical Tretament part

Albumin

Intervention Type BIOLOGICAL

Standard Medical Tretament part

Interventions

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Darbepoetin

Darbepoetin will be given s/c at dose of 40 mcg once a week (total 4 doses) for 1 month

Intervention Type DRUG

G-CSF

G-CSF will be given at a dose of 5 µg/kg s/c at days 1, 2, 3, 4, 5 and then every third and 7th day till day 30

Intervention Type DRUG

Lactulose

Standard Medical Tretament part

Intervention Type DRUG

Albumin

Standard Medical Tretament part

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

1. Age 18-70 years
2. Decompensated cirrhosis patients
3. Uncomplicated ascites,
4. CTP ≤ 9B and MELD \<16
5. BM Hematopoietic stem cell reserve \> 0.4
6. Given informed consent

Exclusion Criteria

1. Patients with age less than 18 years or more than 65 years
2. Lack of informed consent
3. Patients with a history of serious allergic reactions to the active component, filgrastim, other human granulocyte colony-stimulating factors, or any of the ingredients
4. Evidence of alcoholic hepatitis/active alcohol abuse last intake ≤ 3 months
5. Suspected autoimmune hepatitis (ANA/ASMA-positive in titers 1:80 and/ or IgG 1.5 times upper limit of normal),
6. Hemolytic anaemia -Sickle cell disease or thalassemia
7. Patients with Grade III ascites /complicated ascites
8. Patients with large spleen (size ≥ 15cm)
9. Recent variceal bleeding in less than 42 days
10. Patients with any focus of sepsis as proven by culture positivity or presence of spontaneous Bacterial Peritonitis (SBP)
11. H/o Seizures
12. Hepatocellular Carcinoma (HCC) or other malignancy
13. Acute Kidney Injury (AKI) with serum Creatinine \>1.5 mg/ dl,
14. Multi-organ failure,
15. Hepatic Encephalopathy or prior history of HE in less than 6months
16. HIV seropositivity,
17. Uncontrolled essential hypertension, CAD /Stroke
18. Massive hydrothorax
19. Pregnancy
20. Viral etiology of liver disease
21. Chronic kidney disease
22. Portal vein thrombosis
23. Planned for LT
24. Bone marrow hematopoietic stem cells \< 0.4
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institute of Liver and Biliary Sciences, India

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dr Manoj Kumar Sharma, DM

Role: STUDY_DIRECTOR

Institute of Liver and Biliary Sciences

Locations

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Institute of Liver & Biliary Sciences (ILBS)

New Delhi, National Capital Territory of Delhi, India

Site Status

Countries

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India

Central Contacts

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Dr Shreya Singh, MD

Role: CONTACT

01146300000

Dr Manoj Kumar Sharma, DM

Role: CONTACT

01146300000

Facility Contacts

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Dr Shreya Singh, MD

Role: primary

01146300000

Other Identifiers

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ILBS-Cirrhosis-73

Identifier Type: -

Identifier Source: org_study_id

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