Enhanced Liver fibrosis (ELF) test to Uncover Cirrhosis as an Indication for Diagnosis and Action for Treatable Events
ISRCTN | ISRCTN74815110 |
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DOI | https://doi.org/10.1186/ISRCTN74815110 |
Secondary identifying numbers | RP-PG-0707-10101 |
- Submission date
- 06/08/2009
- Registration date
- 11/11/2009
- Last edited
- 29/12/2020
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Digestive System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Plain English summary of protocol
Not provided at time of registration
Contact information
Prof William Rosenberg
Scientific
Scientific
Windeyer Institute of Medical Sciences
46 Cleveland Street
London
W1T 4JF
United Kingdom
Phone | +44 20 7794 0500 |
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w.rosenburg@ucl.ac.uk |
Study information
Study design | Prospective multicentre randomised controlled trial |
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Primary study design | Interventional |
Secondary study design | Randomised controlled trial |
Study setting(s) | Hospital |
Study type | Diagnostic |
Participant information sheet | Not available in web format, please use the contact details below to request a patient information sheet |
Scientific title | Evaluating the benefits for patients and the UK National Health Service (NHS) of new and existing biological fluid markers in liver and renal disease: a prospective multicentre randomised trial |
Study acronym | ELUCIDATE |
Study objectives | The primary aim of the study is to evaluate the benefits to patients and the NHS of new and existing biological fluid markers in liver and renal disease, which aims to develop a stringent approach to protein biomarker evaluation. This trial will determine whether the use of the enhanced liver fibrosis (ELF) test will significantly alter the diagnostic timing and subsequent management of cirrhosis of the liver in order to reduce serious complications and improve outcomes for patients and service provision. |
Ethics approval(s) | Not provided at time of registration |
Health condition(s) or problem(s) studied | Chronic liver disease |
Intervention | Patients will be randomised to either: 1. ELF arm: patients in the ELF arm will undergo follow-up screening for cirrhosis with the ELF test 2. Standard care arm: patients in the standard care arm will undergo standard follow-up screening for cirrhosis Patients will be followed up at 6 monthly intervals until 30 months after randomisation. |
Intervention type | Other |
Primary outcome measure | Time from clinical diagnosis of cirrhosis to incidence of any of the following severe complications: 1. Variceal haemorrhage 2. Mortality due to variceal haemorrhage 3. Spontaneous bacterial peritonitis 4. Mortality due to hepatocellular cancer (HCC) Patients will undergo follow-up visits at 6-monthly intervals, increasing to 3-monthly intervals after diagnosis of cirrhosis, for 30 months post-randomisation. Outcome data will be collected at each visit. |
Secondary outcome measures | 1. Time from randomisation to clinical diagnosis of cirrhosis (to allow instigation of prophylaxis and screening) 2. Detection and timing of complications following cirrhosis, including: 2.1. Detection of small varices 2.2. Detection of large varices 2.3. Incidence of treatable hepatocellular cancer (HCC) 2.4. Incidence of inoperable HCC 3. All causes of mortality 4. Economic evaluation of the ELF test in the early detection of cirrhosis and as such in the initiation of measures to reduce the incidence of severe complications following cirrhosis Patients will undergo follow-up visits at 6-monthly intervals, increasing to 3-monthly intervals after diagnosis of cirrhosis, for 30 months post-randomisation. Outcome data will be collected at each visit. |
Overall study start date | 01/09/2009 |
Completion date | 01/09/2014 |
Eligibility
Participant type(s) | Patient |
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Age group | Adult |
Lower age limit | 18 Years |
Sex | Both |
Target number of participants | 1000 |
Total final enrolment | 878 |
Key inclusion criteria | Registration: 1. Patients with chronic liver disease and pre-cirrhotic moderate to severe fibrosis as classified by clinical, laboratory, or histological evidence, due to viral hepatitis B or C, non-alcoholic fatty liver disease, alcoholic liver disease, primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), haemochromatosis, or combinations of these diseases 2. Clinical evidence of chronic liver disease as evidenced by documented abnormalities of liver function for more than six months including: 2.1. Elevated liver enzymes (alanine aminotransferase [ALT], asparate aminotransferase [AST], gamma glutamyl-transferase [GGT]) 2.2. Elevated bilirubin with raised liver enzymes 2.3. Symptoms or signs of chronic liver disease (including jaundice, clubbing, palmar erythema, spider naevae) 3. Chronic liver disease due to: 3.1. Virus-serological and nucleic acid evidence of chronic Hepatitis C, chronic Hepatitis B 3.2. Fat: ultrasound evidence of fatty liver disease 3.3. Alcohol: history of excessive alcohol consumption 3.4. Autoimmune hepatitis (smooth muscle antibodies [SMA], anti-nucleur antibodies [ANA], liver-kidney-microsome antibodies [LKMA] and raised immunoglobins) 3.5. Primary biliary cirrhosis (anti-mitochondrial antibodies [AMA], M2 antibodies) 3.6. Primary sclerosing cholangitis (endoscopic retrograde cholangiopancreatography [ERCP] or magnetic resonance cholangiopancreatography [MRCP] evidence of beading of biliary tree) 3.7. Haemochromatosis-HFE genotype HDCY or HHYY with liver biopsy evidence of iron overload 4. Aged greater than or equal to 18 years old and less than 75 years of age, either sex 5. Give their written, informed consent to participate 6. Likelihood of ability to comply with the follow-up schedule 7. Life expectancy greater than 6 months Randomisation: 8. An ELF score of greater than or equal to 10.5 |
Key exclusion criteria | Registration: 1. Unable to provide consent 2. Clinical, histological or laboratory diagnosis of cirrhosis (other than ELF) such as hepatic impairment as evidenced by any one of the following: 2.1. Platelets less than the lower limit of normal (LLN) 2.2. Albumin less than LLN 2.3. Ultrasound of other imaging evidence of cirrhosis (coarse echo texture, irregular outline to liver, splenomegally) OR 3. Any episode of hepatic decompensation compatible with cirrhosis including: 3.1. Encephalopathy, variceal bleeding, ascites 3.2. Established diagnosis of hepatocellular cancer 3.3. Elevated alpha feto-protein without investigation to exclude HCC 4. Previously screened and found ineligible for the ELUCIDATE Trial Note that human immunodeficiency virus (HIV) co-infection is NOT an exclusion criterion. Randomisation: 5. An ELF score of less than 10.5 |
Date of first enrolment | 01/09/2009 |
Date of final enrolment | 01/09/2014 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
Windeyer Institute of Medical Sciences
London
W1T 4JF
United Kingdom
W1T 4JF
United Kingdom
Sponsor information
University of Leeds (UK)
University/education
University/education
Woodhouse Lane
Leeds
LS2 9JT
England
United Kingdom
Phone | +44 (0)113 243 1751 |
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governance-ethics@leeds.ac.uk | |
Website | http://www.leeds.ac.uk/ |
https://ror.org/024mrxd33 |
Funders
Funder type
Government
National Institute for Health Research (NIHR) (UK) - Programme Grant for Applied Research (PGfAR) (ref: RP-PG-0707-10101)
No information available
Results and Publications
Intention to publish date | |
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Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Not provided at time of registration |
Publication and dissemination plan | Not provided at time of registration |
IPD sharing plan |
Study outputs
Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
---|---|---|---|---|---|
Results article | results | 01/06/2018 | 29/12/2020 | Yes | No |
Editorial Notes
29/12/2020: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
18/11/2016: No publications found in PubMed, verifying study status with principal investigator.