Covert Hepatic Encephalopathy
Conditions
Keywords
Covert Hepatic Encephalopathy, Cirrhosis
Brief summary
Randomized crossover pilot clinical trial in which 10 cirrhotic patients with covert hepatic encephalopathy (CHE) will be assigned to take GELSECTAN® (TID) or placebo for 30 days. After a washout period of 15 days, the treatment branches will be interchanged. The objective of the trial is to obtain pilot variances to design a phase II trial, in which the efficacy of the treatment will be tested. As an exploratory objective, the efficacy of the product in the treatment of covert hepatic encephalopathy will be analyzed. Main endpoint Improvement in CHE after 30 days of treatment with GELSECTAN®, measured by the Psychometric hepatic encephalopathy score (PHES)
Interventions
DIETARY_SUPPLEMENTGelsectan
Xyloglucan, vegetable protein and xylooligosaccharides
Sponsors
Consorci Sanitari de l'Alt Penedès i Garraf
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
1. Age between 18 and 85 years. 2. Liver cirrhosis defined by a previous liver biopsy or by clinical data. 3. Presence of minimal hepatic encephalopathy (MHE) defined by two psychometric methods (PHES and / or S-ANT and / or Sloop-test). 4. Adequately informed patients who grant their written consent to participate in the study.
Exclusion criteria
1. Alternative neurological diagnosis. 2. Hepatic encephalopathy stage ≥2 using the adapted West-Haven scale. 3. Terminal disease. At the discretion of the doctor, where the patient is in an irreversible situation, in which hepatic encephalopathy is a final manifestation. 4. Presence of Acute-on-chronic liver failure defined by the presence of decompensated liver cirrhosis with severe organ or multi-organ failure. 5. MELD score greater than 25 at the time of inclusion. 6. Hospitalization for any reason. 7. Neurological or psychiatric comorbidity that makes the evaluation of hepatic encephalopathy difficult. This includes patients with mental illnesses (dementia, cerebrovascular disease with sequelae, Parkinson's disease, schizophrenia). 8. Active digestive bleeding. Before inclusion, there must have been a 48-hour period without signs of bleeding. 9. Patients with hypersensitivity or allergy to any of the components of GELSECTAN® (grape, pea). 10. Clinical situations in which the administration of oral feeding is contraindicated. 11. Active oncological processes, including hepatocarcinoma. 12. Active infection of any origin. 13. Acute renal failure (AKI). Defined by the current diagnostic criteria of the KDIGO group (Kidney Disease Improving Global Outcomes). 14. Dehydration Diagnosed by physical examination of the patient. 15. Severe hyponatremia. Defined by plasma sodium \<130 mEq / dl. 16. Concomitant use of sedative drugs, such as benzodiazepines, morphic or derivatives (methadone, tramadol ...) 17. Active drug and/or alcohol use. In each case of clinical suspicion of drug use, an analysis of toxins in urine will be carried out, which includes cocaine, cannabis, opiates. All patients with confirmed alcohol consumption greater than 3 UBD in men or 2 UBD in women will be excluded. 18. Consumption of drugs currently indicated for the treatment of HE: Lactulose, lactitol and antibiotics. 19. Participation in another clinical trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Covert Hepatic Encephalopathy change | 30 days | Covert Hepatic Encephalopathy change after 30 days of treatment with GELSECTAN®, by means of the Psychometric hepatic encephalopathy score (PHES), being patients classified as having MHE when their PHES is less than -4 |
Countries
Spain
Outcome results
None listed