Status:

RECRUITING

BCAA vs. Rifaximin in Patients With Cirrhosis for Secondary Prophylaxis of HE

Lead Sponsor:

Post Graduate Institute of Medical Education and Research, Chandigarh

Collaborating Sponsors:

Indian Council of Medical Research

Conditions:

Hepatic Encephalopathy

Decompensated Cirrhosis

Eligibility:

All Genders

18-65 years

Phase:

PHASE4

Brief Summary

Rationale * Patients who recover from an episode of overt HE(OHE) are at risk of recurrent episodes of HE and persistent minimal hepatic encephalopathy, impacting their daily functioning and mental h...

Detailed Description

Hepatic encephalopathy (HE), a complex neuropsychiatric syndrome arising from liver dysfunction and the establishment of portosystemic shunts (PSS), presents a significant clinical challenge, marked b...

Eligibility Criteria

Inclusion

  • Cirrhosis defined by standard clinical, ultrasonographic findings and/or histological criteria. Cirrhosis of any etiology may be included. However, patients with cirrhosis due to autoimmune hepatitis must be on stable corticosteroid doses for ≥3-month period before study inclusion; those with viral hepatitis, must similarly be on anti-viral therapy with controlled viremia or with SVR.
  • Any gender
  • Discharged from the hospital following an episode of overt hepatic encephalopathy.
  • Participants able to give informed consent

Exclusion

  • Subjects with active bacterial or fungal infection
  • Subjects with active or very recent gastrointestinal bleeding in the last 2 weeks.
  • Current overt hepatic encephalopathy, defined as grade II-IV hepatic encephalopathy according to the West-Haven classification.
  • Conditions that can impact interpretation of cognitive function:
  • i) Untreated viremic hepatitis C virus infection ii) Established neurological/degenerative disorders iii) Patient undergoing active alcohol withdrawal treatment Iv) Patient is intoxicated or under the influence of illicit drugs as per clinician assessment V) Treatment with antipsychotics or other psychotropic drugs with sedative effects
  • Patients with active hepatocellular carcinoma or history of hepatocellular carcinoma that is in remission for less than six months.
  • Patients with a history of significant extrahepatic disease with impaired short-term prognosis, including: i) Congestive heart failure New York Heart Association Grade III/IV or ejection fraction\<30% ii) COPD: GOLD \>2, ii) Chronic kidney disease with serum creatinine \>2mg/dL or under renal replacement therapy.
  • Patients with current extra hepatic malignancies, including solid tumours and hematologic disorders.
  • Patients with MELD\>20
  • Patients with mental incapacity, or those unlikely to survive 12 weeks or any other reason considered by the investigator precluding adequate understanding, cooperation, or compliance in the study activities.
  • Patients with TIPS shunt in situ
  • Pregnancy (urine pregnancy test at inclusion)
  • Refusal or inability to give informed consent

Key Trial Info

Start Date :

February 1 2025

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

August 1 2027

Estimated Enrollment :

336 Patients enrolled

Trial Details

Trial ID

NCT06538077

Start Date

February 1 2025

End Date

August 1 2027

Last Update

June 10 2025

Active Locations (1)

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1

PGIMER

Chandigarh, India