Carvedilol tablets compared with endoscopic banding treatment in preventing rebleeding from oesophgaeal varices
| ISRCTN | ISRCTN69643049 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN69643049 |
| Clinical Trials Information System (CTIS) | 2006-000670-74 |
| Protocol serial number | RN03GA006 |
| Sponsor | Greater Glasgow & Clyde (UK) |
| Funder | Greater Glasgow & Clyde Health Board (UK) |
- Submission date
- 19/11/2013
- Registration date
- 06/12/2013
- Last edited
- 18/10/2016
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Digestive System
Plain English summary of protocol
Background and study aims
In patients with chronic liver disease, rebleeding after a first variceal bleed (bleeding from the blood vessels in the oesophagus [food pipe] or stomach) is common, but is reduced by endoscopic therapy (band ligation) of the varices (dilated blood vessels). Initial studies have suggested that propranolol with or without isosorbide mononitrate tablets may be equally effective in reducing rebleeding and are cheaper and easier to take.
Recent data suggests that carvedilol tablets may be the best medical therapy to reduce the risk of variceal bleeding. Therefore our aim was to investigate whether oral carvedilol therapy was superior to standard endoscopic band ligation at preventing rebleeding following a first variceal bleed.
Who can participate?
We aim to recruit 152 patients, male or female, aged between 18 and 75 with a diagnosis of oesophageal variceal bleeding and cirrhosis.
What does the study involve?
Patients who are stable in hospital after a first variceal bleed will be invited to enter the study. Eligible patients who consent will be randomly allocated to receive either oral carvedilol (6.25 mg for one week, then 12.5 mg daily thereafter) or standard endoscopic band ligation of their varices. Patients will be followed up until 6 months after the last patient is allocated.
What are the possible benefits and risks of participating?
There will be no immediate direct benefit to those taking part. However, there should be benefits to future patients because the results of the study are likely to influence how we treat similar patients in the future. The risks of carvedilol therapy are the same as those of any tablet which may reduce blood pressure, including dizziness or fainting.
Where is the study run from?
This multicentre study is being run from Glasgow Royal Infirmary. Patients will be recruited in Scotland, from Glasgow Royal Infirmary (the lead coordinating centre), the Royal Infirmary of Edinburgh, Gartnavel General Hospital Glasgow and the Southern General Hospital Glasgow.
When is the study starting and how long is it expected to run for?
The recruitment started in June 2006 and will run until the estimated number of patients has been recruited, which is expected to be end of 2013.
Who is funding the study?
Greater Glasgow & Clyde Health Board (UK).
Who is the main contact?
Dr Adrian Stanley
adrian.stanley@ggc.scot.nhs.uk
Contact information
Scientific
c/o GI Unit
Glasgow Royal Infrimary
Castle St
Glasgow
G4 OSF
United Kingdom
| Phone | +44 141 211 4073 |
|---|---|
| adrian.stanley@ggc.scot.nhs.uk |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Randomised controlled study |
| Secondary study design | Randomised controlled trial |
| Study type | Participant information sheet |
| Scientific title | Multicentre randomised controlled study comparing carvedilol with endoscopic band ligation in the prevention of variceal rebleeding |
| Study objectives | The aim of this study is to investigate whether therapy with oral carvedilol tablets superior to endoscopic variceal band ligation in preventing rebleeding from varices. |
| Ethics approval(s) | Glasgow Royal Infirmary North Glasgow NHS Trust Ethics Committee, 26/04/2004, ref: 03GA006 |
| Health condition(s) or problem(s) studied | Variceal rebleeding in cirrhotic patients |
| Intervention | Oral carvedilol tablets versus endoscopic band ligation Carvedilol is 6.25 mg once daily for one week and if tolerated then 12.5 mg once daily until the study is completed (6 months after the last patient is randomised) Band ligation is done every 2-3 weeks until eradication then patient is endoscoped 6 monthly, with further bands applied as necessary. |
| Intervention type | Drug |
| Phase | Not Applicable |
| Drug / device / biological / vaccine name(s) | Carvedilol |
| Primary outcome measure(s) |
Variceal rebleeding is monitored when it occurs during follow-up. Patients will be followed up until 6 months after the last patient is randomised. |
| Key secondary outcome measure(s) |
1. Mortality |
| Completion date | 31/12/2013 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Adult |
| Lower age limit | 18 Years |
| Sex | All |
| Target sample size at registration | 152 |
| Key inclusion criteria | 1. Male or female aged ≥18 and <75yrs 2. Endoscopic diagnosis of oesophageal variceal bleeding 3. Cirrhosis (based on previous liver biopsy or clinical, biochemical and ultrasonographic findings) |
| Key exclusion criteria | 1. Age <18 or >75 years 2. Advanced malignancy or another condition associated with a life expectancy of < 6/12 months 3. Previous transjugular intrahepatic portosystemic shunt (TIPS) or porto-caval shunt surgery 4. Portal vein thrombosis 5. Obstructive airways disease 6. Severe peripheral vascular disease 7. Heart block 8. Severe heart failure 9. Pregnancy 10. Type I diabetes mellitus 11. Gastric variceal bleed 12. Treatment with beta blockers or alpha blockers within 4 weeks of index bleed |
| Date of first enrolment | 06/06/2006 |
| Date of final enrolment | 31/12/2013 |
Locations
Countries of recruitment
- United Kingdom
Study participating centre
G4 OSF
United Kingdom
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|---|
| IPD sharing plan summary | 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 | 01/11/2014 | Yes | No | |
| Participant information sheet | Participant information sheet | 11/11/2025 | 11/11/2025 | No | Yes |
Editorial Notes
18/10/2016: Publication reference added.
