Liver Cirrhosis, Portal Hypertension
Conditions
Keywords
Portal Hypertension, Esophageal Varices, Carvedilol
Brief summary
Patients who have completed 2-years treatment in RCT Study of carvedilol will receive another 2-years extension therapy, aiming to investigate the long-term efficacy of carvedilol for the prevention of esophageal varices in treated HBV cirrhotic patients.
Detailed description
Carvedilol has been shown to be more potent in decreasing portal hypertension than propranolol. But the efficacy of carvedilol to prevent esophageal varices progression in nucleoside analogue (NUCs) treatment HBV related cirrhotic patients was unclear. Previous RCT study aimed to explore the effects of carvedilol for the prevention of the esophageal varices progression on HBV cirrhotic patients with anti-viral therapy has been conducted (NCT03736265). Patients who have completed 2-years treatment in RCT Study of carvedilol will receive another 2-years extension therapy, aiming to investigate the long-term efficacy of carvedilol for the prevention of esophageal varices in treated HBV cirrhotic patients. Patients were allocated according to the outcome of EDGs at 2-year during RCT study. Patients will be assessed at baseline and every six months for blood cell count, liver function test, HBVDNA, AFP, prothrombin time, liver ultrasonography, and Fibroscan. A third EGDs will be performed at 4-year.
Interventions
Carvedilol is started at a dose of 6.25 mg once per day, and will increase to a dose of 12.5 mg once per day after 1 week. Target dose will be maintained at 12.5 mg once per day if patients with systolic blood pressure not lower than 90 mm Hg and HR no less than 50 beats/min.
Sponsors
Beijing Friendship Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Subjects who completed the 2-year RCT study of carvedilol in HBV cirrhotic patients with anti-viral therapy; * Subjects who are willing to participate the extension study.
Exclusion criteria
* Subjects who refused to receive 2-year EGD examination during the previous RCT study; * Subjects who could not compliance with the protocol judged by investigators; * Subjects who are not suitable for the study judged by investigators.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The progression incidence of esophageal varices after 4-year therapy | 4-year | Progression of esophageal varices defines as follows: 1. Varices developed from small (F1) to medium or large (F2/F3) 2. Varices developed from medium (F2) to large (F3) 3. New-onset red sign without change in the degree of varices. 4. Bleeding from esophageal varices. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of liver cirrhosis decompensation | 4-year | Cumulative rate of liver cirrhosis decompensation, including bleeding, ascites, hepatic encephalopathy, ect. |
| The incidence of hepatic cellular carcinoma, death or liver transplantation. | 4-year | Cumulative rate of hepatic cellular carcinoma, death or liver transplantation. |
| The change of non-invasive assessment score reflecting liver fibrosis. | 4-year | Higher scores mean a worse outcome. |
| The change of non-invasive assessment score reflecting liver function. | 4-year | Higher scores mean a worse outcome. |
| The dynamic change of liver stiffness quantified by transient elastography. | 4-year | The dynamic change of liver stiffness quantified by transient elastography. |
Countries
China
Contacts
Primary ContactXiaojuan Ou, Dr
Backup ContactXiaoning Wu, Dr
Outcome results
None listed